2025-2026 CHAT Member Registration

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Email *

Parents' Names *

Address *

Parent Phone Number *

Emergency Contact Name and Number *

Name and age of teens, include any 12 year olds who will have their Birthday within the school year. *

Do you intend to host any events?
*

Yes

Maybe.

Release of Liability

We, the undersigned parents/guardians, release CHAT and its officers and members from liability concerning
any injury unless caused by an intentional act of one of the members or officers. This release of liability
applies to my child named on this form as he/she participates in activities sponsored by CHAT.
We, the undersigned, have read this release and fully understand all of its terms. This release is effective
beginning the day this form is submitted unless specifically revoked by us.

We also understand that photographs of our children may be taken at CHAT events and that these may be posted in the CHAT facebook group or used in promotional materials.

Parent signature (type your name to indicate you agree with the liability waiver). *

Do you agree to follow all of the CHAT rules? *

Yes

Required

Send me a copy of my responses.

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