Days Attending *

Monday | 8AM-12PM

Monday | 12PM-3PM

Tuesday | 8AM-12PM

Tuesday | 12PM-3PM

Wednesday | 8AM-12PM

Wednesday | 12PM-3PM

Thursday | 8AM-12PM

Thursday | 12PM-3PM

Friday | 8AM-12PM

Friday | 12PM-3PM

Student Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Cell Phone *

(###)

###

####

Emergency Contact Cell Phone *

(###)

###

####

Release of Liability *

I, the signed parent or legal guardian of the above student hereby consent to his/her attendance at and participation in a program or programs offered by Ridgeview Church ("RVC") and do forever RELEASE, acquit, discharge, and covenant to defend, indemnify and hold harmless RVC, its owners, managers, tutors, volunteers, staff and all persons affiliated with them ("Releasees") from and against any and all actions, claims or suits of any kind or nature arising out of attendance at or participation in the said programs(s) of RVC, including without limitation claims for personal injuries or property damage which I may now have (or hereafter acquire), either individually or as the parent/legal guardian of said minor, as well as any and all claims or rights or action for damages which said minor has or hereafter may acquire, either before or after he/she has reached the age of majority, arising out of his/her participation in RVC's programs(s). I understand that the execution of this Release, Indemnity, and Waiver of Claims document is a condition of the student's attendance at/participation in RVC's programs.

I agree