• KACHEA CO-OP

    Student Information/Medical Release/Waiver of Liability Property Replacement Pledge/Commitment Pledge 2022-2023
  • Emergency Information: In an emergency when parents cannot be reached, please contact:

  • Medical Information

    If there are any known allergies, you must fill out the additional Allergies Form with the details. If there are no known allergies, you do not need to complete the additional form.

  • PARENT’S MEDICAL RELEASE AUTHORIZATION

    My child is physically, mentally and emotionally capable of participating in a cooperative school with other students. I understand that during any of the classes there may be games that require physical exertion. While injury is unlikely, I understand that the possibility exists.

    I give my consent to have a doctor of medicine provide my child with medical assistance and/or treatment if necessary and agree to be financially responsible for the reasonable cost of such assistance and/or treatment. I understand that treatment would be administered if, in the opinion of medical personnel, it is immediately necessary and I cannot be reached in reasonable time to give consent.

    WAIVER OF LIABILITY
    I understand that by placing my child in the Co-Op program, I waive and release any and all rights and claims for damages that I may have against the Co-Op, host church, or any of their representatives, for injuries that may arise out of the program. Photos of my child may be used on the internet or in printed materials by KACHEA.

    PROPERTY REPLACEMENT PLEDGE
    I agree to be financially responsible for any and all property damage that may result from my child’s actions or mine while in attendance at the Co-Op or its functions.

    PLEDGE OF COMMITMENT
    I have read the Co-Op guidelines and agree to them. I agree with and have signed the KACHEA statement of faith and Code of Conduct.

    By registering in the Co-Op I pledge to all of the other families involved that I will have my Co-Op duties as a priority in my life and will fulfill those duties to the best of my ability.


    I HAVE READ AND UNDERSTAND THIS AGREEMENT AND HAVE WILLINGLY PLACED MY SIGNATURE BELOW AS EVIDENCE OF MY ACCEPTANCE OF ALL THE CONDITIONS MENTIONED.

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