Liability Release Form for The Learning Ark of Wilmington
Please read and acknowledge the terms to participate in the program.
Child's Full Name
*
First Name
Last Name
Parent or Guardian's Full Name
*
First Name
Last Name
Parent or Guardian's Email Address
*
example@example.com
Parent or Guardian's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Liability Release Statement: I hereby acknowledge that I am the parent or legal guardian of the above-named child and agree to release The Learning Ark, its staff, and affiliates from any and all liability for injuries or damages that may occur during participation in the pre-k program. I understand and accept the terms of this release.
Signature of Parent or Guardian
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: