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