Registration Form For After-School Programs
Please print, complete, sign and send the form below with to the school office or drop off/mail to NCAARD at 4 Comin Street, New Concord.
Make checks payable to NCAARD.
Click Here to Download a Registration Form
or print the form below.
Program:____________________________________
Child’s Name:________________________________
Gender:____________________Grade:______________
Homeroom Teacher:_____________________________
Home Address: __________________________________
Guardian name: ________________________________
Email: __________________________________
Daytime Phone: _____________________________
Emergency Phone:______________________________
Allergies: _________________________________________
Notes:____________________________________________
Participation Waiver: I understand that participation in any New Concord Area Arts and Recreation District activities is on a voluntary basis. NCAARD shall not be held responsible for any injury or loss of property to me or to members of my family while participating in any NCAARD activity
____________________________________________________
Signature of parent or guardian Date
Publicity waiver: My child’s name and/or photo taken of my child may be used for the purpose of NCAARD publicity. This information may appear on displays showing NCAARD activities, media such as the Daily Jeffersonian, Times Recorder, and the NCAARD Web page.
_____ I agree ____ I do not agree.
