REACH Application July 2011 - June 2012
Please complete the form below *indicates required fields
*Parent's Name(s): *Member Status:
*Address:
*City: *State: *Zip Code:
*Home Phone: Cell Phone:
*Email Address (HIGHLY RECOMMENDED): (If no email enter "no email")
Business or Personal Address or Blog: (these will be listed in the REACH roster)
*Children's Name(s) Birthdate Homeschooled
1.
2.
3.
4.
5.
6.
Please list additional Children here:
We believe the best way to foster a sense of community in our support group is through participation. Therefore, we encourage all families to join at least one committee. Your responsibilities would be to help the committee plan and execute activities on a regular basis. This information will also help us get you connected to others with similar interests.
*Please type YES next to each group in order to sign up for least one of the following:
Explorers (PreK-2nd Grade) Student Council
Pioneers (3rd-5th Grade) Field Day Planning
Trailblazers (6th-8th Grade) End of Year Program
Champions (9th-12th Grade) HERS (Book Sale Planning
If you would be willing to help chair a committee please indicate here
If you would like to start a club
I am interested in joining REACH's Administrative Team
*Who is your accountibility organization? Third Option Other Specify Here
REACH is a support group only - NOT an accountability organization. Joining REACH does not make you "legal"
If you re looking for an accountability group please contact REACH the TOP a third option group exclusively for REACH members. You will need to complete an application for REACH the TOP separately.
By clicking the submit button below, I understand that should my family not adhere to the policies of REACH, our membership in REACH will be cancelled, and any future requests for membership will be reviewed by the Administrative Committee. I agree that submission of this application will be a binding agreement to follow these policies.
Waiver and Release of Liability: This must be read and signed by all members
By typing your name below under signature you are affirming you have read it. In consideration of my involvement and participation under the auspices of the REACH sponsored events and activities, I acknowledge and agree that:
1. I risk the possibility of loss of or damage to property or bodily injury.
2. I knowingly and freely assume all such risk for myself and my children.
3. I, for myself, and on my behalf of my heirs, assign and next of kin, herby release, hold harmless and promise not to sue the REACH homeschool support group, sponsors, facility owners or their officers, official agents and/or employees, with respect to any and all such bodily injury, damage to or loss of personal property except that which is the result of gross negligence and/or willful or wanton misconduct. I have read the above waiver and release, understand that I have given up substantial rights by signing it and sign it voluntarily.
*Signature *Date
Please type your full name in the signature box as accepting this agreement
------ OR -----
