ESL Classes Registration

ESL Classes Registration

All classes take place in the Christ Fellowship Leesville Chapel, Lower Level on Thursdays from 7:00-8:30pm starting September 4th. These classes are for adults ages 18 years and older. No childcare will be provided.
Full Name*

FirstLast
Male/Female*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
Allergies?*
Allergy Details
Other Medical/Health Concerns*
Medical/Health Concern Detail
I would like to receive information through email concerning other Christ Fellowship Leesville church activities.*
Are you currently a member or regular attender of a church?
Church Name
How much English language experience do you have?

ACTIVITY PARTICIPATION AGREEMENT

I acknowledge that participation in the activity described above involves risk to the Participant (and to Participant’s parents or guardians, if Participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, 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 “Activity”), the Participant (or parent/guardian if Participant is a minor) acknowledges and accepts the risks of injury associated with participation in the Activity. The Participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the Activity, as well as for any medical treatment rendered to the Participant that is authorized by the Sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to hereinafter as the “Activity Sponsor”). Further, the Participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the Activity Sponsor for any injury arising directly or indirectly out of the described Activity, whether such injury arises out of the negligence of the Activity Sponsor, 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 the Activity Sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution pursuant to the rules of the American Arbitration Association
I have read and agree to the above Activity Participation Agreement.*

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Photo/Video Use Agreement

I hereby grant, voluntarily and with full understanding, to Christ Fellowship Leesville a license to the following:
1. Use and storage of my name and image or my child’s name and image, by means of digital or film photography, video photography, audio recording or other documentation, with respect to the activity, namely (“Activity”), of Church.
2. Use of any stored data including my name and image or my child’s name and image in printed publications of Church.
3. Use of any stored data including my name and image or my child’s name and image in electronic publications of Church.
4. Use of any stored data including my name and image or my child’s name and image in any Web site created by or for Church for its sole benefit.
5. If I am signing this agreement on behalf of a minor child, I hereby warrant that I am the legal parent or guardian of the child and that I have the legal authority to sign this agreement on behalf of the child.
6. If a dispute over this agreement or any claim for damages arises, I agree to resolve the matter through a mutually acceptable alternative dispute resolution process. If I cannot agree with Church upon such a process, the dispute will be submitted to a three-member arbitration panel of the American Arbitration Association for final resolution.
I grant Christ Fellowship Leesville permission to use images and videos in various publications of the church*
I have read and agree to the above Photo/Video Use Agreement*

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