Christos Registration 2019-20
For students in 3rd-5th Grade. Meets most Wednesdays 6-7pm; check Family News for dates.
Student First Name *
Your answer
Student Last Name *
Your answer
Grade entering in Fall 2019 *
Any relevant medical/behavioral information that would help us help your child be successful? Please include any allergies.
Your answer
Parent 1 Name: *
Your answer
Parent 1 Phone: *
Your answer
Parent 1 Email: *
Email is our primary source of communication with families.
Your answer
Parent 2 Name:
Your answer
Parent 2 phone
Your answer
Parent 2 email
Your answer
Important Information:
General: If I am signing this agreement on behalf of a minor child, I hereby warrant that I am the legal parent or guardian of the child and that I have the legal authority to sign this agreement on behalf of the child. I acknowledge that participation in activities organized by Family of Christ, from date signed to September 7, 2020, involve risk to the participant (and to the participant’s parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage, and financial damage. The participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to as the “activity sponsor”). In the event of emergency treatment, I will be asked to provide my (my child’s) insurance information. Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise. Family of Christ can use and store my (or my child’s) name and image, by means of digital or film photography, video photography, audio recording or other documentation (including but not limited to registration, classroom lists, etc), with respect to activities with Family of Christ. Photos may be used in printed publications, electronic publications, and Web site. When available, verbal permission will be sought for individual social media posts.
By typing my name below, I am agreeing to the following terms: *
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