Group Registration Form

Group Registration Form

Group Registration Form

Ages 18+
Please use this form to register for an Affirmations group!

All groups serve ages 18 & up.

If you are considering joining the group as an ally, please contact us before submitting this form to receive consent from the group for you to attend.

We ask that groups are not observed by students for studies or similar purposes.
Registrant Information
Name*

First NameLast Name
Age*
Must be 18+
Email*
example@example.com
Would you like to receive emails about center happenings?

What group are you interested in?
What questions, if any, do you have about this group?
Queer Parents that attend this group are welcome to bring any children that they have between the ages of 6-12. If you choose to bring a child to this program, the following acknowledgements are required.

1. Waiver and Release of Liability

I, the undersigned, agree to release and hold harmless Affirmations Community Center, its staff, volunteers, and agents from any and all claims, damages, or liabilities arising out of or in connection with my child's participation in the program. This includes any injury or illness sustained during the program, except where such injury or illness is caused by the gross negligence or willful misconduct of the community center.

2. Behavioral Expectations
I acknowledge that my child is expected to follow the rules and guidelines set forth by the Affirmations Community Center during the program. I understand that failure to adhere to these rules may result in my child being removed from the program.

3. Acknowledgment of Risk
I acknowledge that participation in the program may involve certain inherent risks, including but not limited to physical activity and interaction with other children. I assume full responsibility for my child's actions, health, and safety while participating in the program and will be with them during the entirety of the program.
Signature*

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