A HID IN TREASURE

A HID IN TREASURE - After-School Program Registration

Please fill out the form completely to register for the after-school program.
Participant Name*

First NameLast Name
Participant Age*
Participant Birth Date*

MonthDayYear
Date
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Cell Phone*
Please enter a valid phone number.
Parent/Guardian Work Phone
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Participant's School*
Participant's Grade*
T-shirt Size (Youth/Adult S-M-L)*
Emergency Contact Name*

First NameLast Name
Emergency Contact Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Phone*
Please enter a valid phone number.
Authorized Pickup Person 1*

First NameLast Name
Authorized Pickup Person 2

First NameLast Name
Authorized Pickup Person 3

First NameLast Name
Authorized Pickup Person 4

First NameLast Name
******A picture ID will be required prior to release of child/ren to these individuals ******
Medications Taken and Frequency
Health Concerns/Allergies

A HID IN TREASURE

PARENT/GUARDIAN PARTICIPATION RELEASE
I give permission for my child/ren to participate in recreational activities as planned andconducted by A Hid In Treasure, After School Program

First NameLast Name
Parent/Guardian Signature

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Date

MonthDayYear
Date

A HID IN TREASURE

CONSENT TO TREATMENT
If my child/ren should require minor or major treatment and /or medication during thecourse of his/her attendance at or during participation in any recreational activities; I give my permission to A Hid InTreasure, After School Program or medical staff which they may appoint to carry out the necessary treatment and to takemy child/ren to the emergency room of the nearest hospital, if necessary, for the administration of treatment.

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Date

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Date

A HID IN TREASURE

PHOTO RELEASE
Signature

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We are aware that on occasion, a photographer may want to take pictures of participants in theseprograms. It is understood that these pictures will always be taken under the supervision of the instructor and that greatcare will be exercised to assure that the individual or organization will not be embarrassed by their use.

MonthDayYear
Date

A HID IN TREASURE

TRAVEL RELEASE
Signature

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My child/ren has my permission to be transported to and from programs held by A Hid In Treasure,After School Program

MonthDayYear
Date

A HID IN TREASURE

PARENT/GUARDIAN GENERAL RELEASE
We are excited to invite your child to participate in the A.H.I.T After School Program, a place where they can learn, grow,and have fun in a safe environment. We want to ensure that you feel confident in their participation, which is why we have ahighly qualified and thoroughly trained staff ready to handle any emergency situations that may arise.By granting permission for your child to join us, you are not only supporting their development but also acknowledging thatwhile we prioritize safety, unforeseen circumstances may occur. Therefore, we kindly ask that you understand and agreethat A Hid In Treasure, the After School Program, its dedicated staff, and the City of Rock Hill are not liable for any injuries,illnesses, or personal property damages that may happen during the program.In the unlikely event of an injury, we appreciate your understanding that you are waiving any claims against A Hid InTreasure, the organizers, sponsors, staff, the City of Rock Hill, or any appointed volunteers. Additionally, you are waivingany claims related to transportation to and from our activities, except where covered by liability insurance.As a parent or guardian, your approval is vital, and by signing this release, you confirm that you have read and fullyunderstand the terms. Together, let’s ensure a positive and enriching experience for your child that fosters their growth andwell-being. Thank you for trusting us with this important responsibility; we’re excited to embark on this journey with you andyour child!

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Date
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A HID IN TREASURE - After-School Program Registration

******A picture ID will be required prior to release of child/ren to these individuals ******

A HID IN TREASURE

A HID IN TREASURE

A HID IN TREASURE

A HID IN TREASURE

A picture ID will be required prior to release of child/ren to these individuals