• Wednesday, May 21, 2025

    Wednesday, May 21, 2025

    CCS Registration & Release Form
  • Halecrest Park Swim & Tennis Club

    3107 Killybrooke Ln. Costa Mesa CA, 92626
  • Bus Leaves CCS @ 3:15p / Pick Up 5:30pm @ Halecrest Park

  • PROGRAM LEADER

    Middle School Principal
  • STUDENT INFORMATION

    **If you have multiple children participating, please fill out a separate form for each one.
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  • Promotion Party Code of Conduct 


    General Code of Conduct for Students:

    • Kindness and respect for all students and persons in authority 
    • Respect for facilities and other person's property
    • Adherence to the event boundaries 
    • Cell phones are “Away for the Event”. Cell phones are collected at the door, however students can check their phones anytime throughout the event if needed at the designated area
    • Only CCMS students and CCS approved/cleared parent volunteers are allowed at the event

    Dress Code for Students:

    • Students may change after school.
    • Clothing must not violate overall dress code guidelines
    • Pajamas may not be worn 
    • Undergarments should not be visible on male or female students
    • Skirts or shorts should be appropriate in length
    • No  tank tops, low-cut tops, or bare midriffs garments allowed 
    • Leggings or tights may only be worn under loose-fitting, mid-length shorts

    Note to Parents:

    • Students will be checked in at the school and transported to the event.
    • Students must be signed out at the sign-out table.
    • No students will be released to another adult unless there is pre-communication from the parents to Administration.
    • All students must be picked up by 6:30 pm
  • PARENT/GUARDIAN INFORMATION

  • ADDITIONAL PERSON WHO MAY SIGN OUT/PICK UP CHILD

    (Optional)
  • MEDICAL & INSURANCE INFORMATION

  • PARTICIPATION AGREEMENT: I acknowledge that participation in the activity described above involves risk to the participant (and to the participant's parents or guardians, if the participant is a minor and may result in various types of injury including. but not limited to. the following: sickness, exposure to infectlous/communicable disease, bodily injury. death, emotional injury. personal injury. property damage, and financial damage.

    In consideration for the opportunity to participate in the activity described above, the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity. as well as for any medical treatment rendered to the participant that is authorized by Calvary Chapel Schools or its agents, employees. volunteers, or any other representatives (collectively referred to as Calvary Chapel Schools Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless Calvary Chapel Schools for any injury arising directly or indirectly out of the described activity or transportation to and from the activity. whether such injury arises out of the negligence of Calvary Chapel Schools, the participant. or otherwise.

    If a dispute over this agreement or any claim for damages arises. the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process If the participant (or parent/guardian) and Calvary Chapel Schools cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association.

    EMERGENCY PERMISSION: I/we the parents/guardians, do hereby authorize officials of Calvary Chapel Schools to contact directly the persons named on this card, and do authorize the named physician(s) to render such treatment as may be deemed necessary in an emergency. for the health of the child. In the event the physician(s other persons named on this card, or parents cannot be contacted the school officials are hereby authorized to take whatever action is deemed necessary in their judgment. for the health of the aforesald child.

    AUTHORIZATION AND CONSENT TO TREATMENT OF MINOR: I/we the parents/guardians do hereby authorize Calvary Chapel Schools as agents for the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis, treatment, and/or hospital care which is deemed advisable by, and is to be rendered under the general or specific supervision of any physician or surgeon licensed under the provisions of the Medical Practice Act on the medical staff of the licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is givenin advance to provide authority and power on the part of the aforesaid agents. This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. Authorization is hereby given to school personnel to administer first-aid treatment during school activities or to call the paramedics, or rescue squad, as deemed necessary.

    PHOTOGRAPHY RELEASE/HANDBOOK AGREEMENT: I/we the parents/guardians do hereby give permission to Calvary Chapel Schools to use my child's picture. image, or likeness on all Calvary Chapel Schools publications, including school websites and media presentations. I/we the parents/ guardians, agree to follow all pertinent school policies, including those relating to procedures and discipline which are outlined in the parent/student handbook. The handbook can be found at www.calvaryschools.org. Parents are responsible to keep the office informed of any change of address. phone numbers. employer information, and emergency contacts.

  • Confirmation

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

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    Promotion Party Ticket Product Image
    Promotion Party TicketNon-Refundable
    $30.00
      
    Total
    $0.00

    Payment Methods

    creditcard
    After submitting the form, you will be redirected to Apple Pay to complete the payment.
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