Co-op At Victory Registration Form
Parent:
*
First Name
Last Name
Parent Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Email:
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I would like to...
*
Teach a class (curriculum provided)
Assist with a class
Whatever is needed
What class would you like to be a part of?
*
Rows
Not Interested
Somewhat Interested
Very Interested
I'm made for this
Nursery
Life Skills
Art
S.T.E.M.
Student Registration
This section is only for the kids that will be participating in classes. Pricing: 1st child =$75 | 2nd child =$50 | 3rd-100th child=$25 (This is a non refundable fee)
How many children will you be putting in classes?
*
Student Information
*
Nursery Registration
This is only for kids that will be in the nursery (There is no charge for nursery age)
Will you be bringing children into the nursery during class?
*
Yes
No
Nursery Children Information
Liability Waiver
Photo Release
*
I give permission for my child to be photographed or video-recorded during co-op activities for promotional materials, social media, or church publications.
I do NOT give permission for my child(ren) to be included in any photos or videos.
Parent Signature:
*
Submit
Submit
Should be Empty: