CHC Activities Guest Parking Permit Valid for Lots 3 & 4 only Issued

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CHC Activities Guest Parking Permit Valid for Lots 3 & 4 only Issued
CHC Activities
Guest Parking Permit
Valid for Lots 3 & 4 only
Mt. Airy Learning Tree
Issued by
6601 Greene Street
Philadelphia, PA 19119
215-843-6333
Permit must be displayed on dashboard
Permit must be displayed on dashboard
Issued by
6601 Greene Street
Philadelphia, PA 19119
215-843-6333
Mt. Airy Learning Tree
Valid for Lots 3 & 4 only
CHC Activities
Guest Parking Permit
MT. AIRY LEARNING TREE
Mt. Airy Learning Tree
6601 Greene Street
Philadelphia, PA 19119-3114
215-843-6333
fax 215-843-6655
[email protected]
www.mtairylearningtree.org
ENROLLMENT & RELEASE FORM
I, _____________________________________________________,
hereby enroll in the Mt Airy Learning Tree course:
_______________________________________________________________________.
Recognizing that this is a community activity, and that use of the tools and/or concepts
taught in this course entails some risk, I hereby assume all such risks and release Mt. Airy
Learning Tree, Mt. Airy Community Services Corporation, and their agents and
employees from liability for any injury or harm which may result from or be related to
my participation in this course. I understand that the course is being taught by
independent contractor(s) not employed by Mt. Airy Learning Tree or Mt. Airy
Community Services Corporation, and I also release the teacher(s) from any liability.
Student Signature: ________________________________________________________
Date: ________________________________
Parental/Guardian consent for students under eighteen years of age:
I hereby consent to my child’s enrollment in this course and join in the foregoing release.
Parent/Guardian Signature: _________________________________________________
Date: ________________________________