CHAOS Student Registration
Welcome parents, please fill out this form to regsiter your student for CHAOS for 2021/2022.
NOTE: If student DOES NOT have a unique email address and/or mobile number number, please leave this blank.
Primary Parent/Guardian Information
Please use unique email addresses and phone numbers.
Secondary Parent/Guardian Information
Please use unique email addresses and phone numbers. If not applicable, leave blank and fill out Additional Emergency Contact Information.
Additional Emergency Contact
If you DID NOT fill out information for 2 parents/guardian, please provide an additional emergency contact. Please use unique email addresses and phone numbers. We will ONLY contact this person in the case of emergency where parents/guardians cannot be reached.
Student Permission Forms
I give my student permission to go off campus with a college-age or adult leader when notified in advance.
I hereby grant CHAOS, Nazareth Evangelical Lutheran Church, and Orchard Hill Church permission to use my student's likeness and name in photographs, video recordings or electronic images in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of the organization and will not be returned. I hereby irrevocably authorize the organization to edit, alter, copy exhibit, publish or distribute these images for purposes of publicizing the organization's programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image. I hereby hold harmless and release and forever discharge the organization from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I hereby certify that I am the parent or guardian of the student on this form, and do hereby give my consent without reservation to the foregoing release on behalf of this person.