Early Childhood Enrichment Winter 2019

Come join us this fall for 8 weeks of music, stories, movement and fun
for young children, pre-school to age 6.
 
Winter session starts January 15 or 16, 2019.
 
Choose from one of four sessions, Tuesday or Wednesday at either 9am or 10:30am.  THE COST IS $10 PER CHILD for the entire session (ending March 12 and 13) - payable at the first class session. 
 
We will meet in "The Well" (formerly the ARK) at Christ Memorial Church. 
 
For more info or questions, contact Mrs. Laurie Dekker at (616) 335-9725 or by email at laurie.dekker@gmail.com.
My child will attend the following session:
Tuesdays
Wednesdays
My child will attend the following session:
Tuesdays
Wednesdays
My child will attend the following session:
Tuesdays
Wednesdays

In checking YES, I AGREE on this document, I hereby certify that the ALL of the enclosed information is correct. In the event that I cannot be reached, I hereby give permission to the physician selected by the CMC staff to obtain proper medical diagnosis, hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child as named above.

I also acknowledge I have read, understand and accept the terms listed below:

RELEASE OF LIABILITY

The PARTICIPANT, their PARENTS, GUARDIANS, HEIRS, ASSIGNS and REPRESENTATIVES hereby release Christ Memorial Reformed Church, its staff members, volunteers, agents and representatives of any and all liability for any loss, injury, or property damage which may be the result of any aspect of any mission trip, retreat, event, excursion or regular programming/classes including transportation to/from these activities. The Participant may participate in activities as mentioned above located both on and off CMC property for the duration of this release. The Participant and the Participant's Parent(s) and/or Guardian(s) understand, acknowledge and accept that there are inherent risks, both known and unknown, in travel and in the activities in which the participant will engage in during mission trip, retreat, event, excursion or regular programming/classes.

The Participant and the Participant's Parent(s) and/or Guardians also understand and acknowledge that individual Participants are not covered under any policy of insurance held by Christ Memorial Reformed Church and that Participants must provide any and all insurance coverage for themselves, including, but not limited to health, life and liability insurance.

Photographs or videos may be taken during the experience of the mission trip, retreat, event, excursion, or regular programming/classes you or your child will be participating in. By signing this form, you are authorizing Christ Memorial Church to use those videos and/or photographs in any manner deemed appropriate by Christ Memorial Church, including, but not limited to use in promotional materials or church services.

This release is valid from January 1, 2018 to December 31, 2019.

 *

Household / Adult Primary Contact

Relationship to Participants: *
 
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