Student Success Center Registration 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 Grade (as of 9/1/2020) * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Parent/Guardian Name * Contact Email * Contact Cell Phone * (###) ### #### Emergency Contact Name * Emergency Contact Relationship * Emergency Contact Cell Phone * (###) ### #### Academic Concerns Health Concerns (including allergies) 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 Thank you for registering your child to participate in our Student Success Center! We will be in touch with you shortly.
