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Wellston After School Program/Outings Application
This is the Jubilee Partners Wellston enrollment application
for Fall 2025/ Spring 2026
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Email *
Student's name *
Student's Birthday *
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Student's School *
Student's Grade *
Any allergies or special instructions *
Days attending *
Required
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Parent or guardian name(s) *
Home address *
Guardian Phone number *
By checking this box I agree to allow Jubilee Partners to transport my child and seek needed medical attention if needed *
Required
I, the parent or guardian of the above-named child, hereby register him/her for participation in Jubilee Partners programs and activities and fully agree to the rules and regulations of Jubilee Partners and do hereby release Jubilee Partners and its directors, representatives, employees, and volunteers from any liability.  I, the parent or guardian, release Jubilee Partners from all responsibilities from injuries of any nature incurred while participating in Jubilee Partners programs.   I understand that my child will be supervised by a professional at all times, and that medical insurance is my responsibility. Emergency Medical Treatment In the event that my child becomes ill or sustains an injury while in the care of or under the supervision of the Jubilee Partners coordinators and volunteers or other Jubilee Partners representatives, they are given permission to administer first aid for his/her relief.  In case of emergency, permission is given to take my child to the nearest appropriate emergency or clinic facility.                                                                                    
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This agreement is made and entered into as of August 1st , 2025 to July 31st, 2026 by and between Jubilee Partners and the above listed child. I hereby grant permission for Jubilee Partners to use photographs for use in any and all media and methods of transmission and/or distribution now or hereafter known, including but not limited  to  film,  print,  video,  computer,  Worldwide  Web,  Internet  Website,  Email, computer network, and digital reproduction and distribution, for illustration, art promotion, advertising, trade, sales, or any other purpose whatsoever. I hereby waive any right to inspect or approve the photographs or electronic matter that  may be used in conjunction with them now or in the future, whether that use is known to the organization  or  unknown,  including  but  not  limited  to  any  re-use,  distortion,  blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur in relation to the finished product. I hereby agree to hold harmless Jubilee Partners from and against any claims, and waive any right to royalties or other compensation arising from or related to the use of the photographs.
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Type your name below
By typing your name below you are acknowledging this as your Digital Signature and are confirming the information you have provided in this form. 
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Date
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