Providence High School Class New Student Registration
 
Providence High School Class New Student Registration
Your Email Address  * 
PLEASE COMPLETE THE REGISTRATION INFORMATION BELOW.
(1st) Student's First & Last Name  * 
(1st) Student's Date of Birth: (MM/DD/YYYY)  * 
Shirt Size
(2nd) Student's First & Last Name
(2nd) Student's Date of Birth (MM/DD/YYYY)
Shirt Size
(3rd) Student's First & Last Name
(3rd) Child’s Date of Birth: (MM/DD/YYYY)
Shirt Size
(4th) Student's First & Last Name
(4th) Student's Date of Birth: (MM/DD/YYYY)
Shirt Size
Father’s/Guardian’s First & Last Name
Father’s Phone:
Mother’s/Guardian’s First & Last Name
Mother’s Phone:
Address:
City:
Zip:
Emergency Contact other than parents (name & phone#)
ALLERGIES or MEDICAL CONDITIONS: Please list name(s) of child/children along with any allergies or medical conditions that we need to be aware of
I understand that my child is participating in PROVIDENCE HIGH SCHOOL AT CENTRAL VALLEY BAPTIST CHURCH on his or her own accord and at his or her own risk.
In the event of an emergency, I hereby give permission to the church or school-appointed sponsors who are with my child at the event named below to obtain medical assistance for my
Sponsor: CENTRAL VALLEY BAPTIST CHURCH ; 600 n. Ten Mile Rd., Meridian, ID 83642 Activity and Date: PROVIDENCE HIGH SCHOOL 2018 - 2019 SCHOOL YEAR
In consideration of the permission granted to the participant named above, by the above named SPONSOR/CHURCH to participate in the above described SCHOOL AND ACTIVITIES,
I hereby release said SPONSOR/CHURCH, its agents ad employees, from all actions, causes of action, damages, claims, or demand which I, my heirs, executors, administrators,
or assigns may have against said SPONSOR/CHURCH, THEIR AGENTS AND EMPLOYEES, and other above described parties for all personal injuries known or unknown which the participant
named above, has or may incur by participating in the above described SCHOOL AND ACTIVITIES. I, the undersigned, have read this release and understand all its terms.
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