Registration for the Center Child's First Name Last Name Age Child School Emergency Medical Information Asthma Diabetes Fainting Spells Convulsion Emergency Medical Information Contact Lens Heart Trouble High Blood Pressure Other Other Parent/Guardian First Name Parent/Guardian Last Name Email Address Phone Waiver and Release Form Acknowledgment and Assumption of Risk: I understand and agree that participation in programs and activities at the Community Lifestyle Center may involve inherent risks, including but not limited to physical activities, sports, arts, crafts, and other recreational or educational activities. I acknowledge these risks and assume full responsibility for my or my child’s participation. Release of Liability: In consideration of being allowed to participate in activities at the Community Lifestyle Center, I hereby release and discharge Community Lifestyle, its staff, volunteers, and affiliates from any and all liability, claims, or demands arising out of or related to any loss, damage, or injury, including death, that may occur during my or my child’s participation.Medical Treatment Authorization: In the event of a medical emergency, I authorize the staff at the Community Lifestyle Center to obtain medical treatment for me or my child. I understand that I am responsible for any costs associated with such treatment.Photography/Media Release: I grant permission for photographs or videos of me or my child participating in activities at the Community Lifestyle Center to be used for promotional or educational purposes.Acknowledgment of Rules and Policies: I understand that participants must follow all rules and policies set by the Community Lifestyle Center. Failure to comply may result in dismissal from the programs and the center. Submit Registration
