Parent's Name *

First Name

Last Name

Parent's Phone *

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Emergency Contact *

First Name

Last Name

Emergency Contact Phone *

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I hereby solely and expressly assume liability for all risks and waive any claim I might have against The Treehouse or individuals acting in the capacity as agents of the organization (staff members, independent contractors, volunteers, etc.). I assume full legal liability for my child’s actions in class and release The Treehouse and agents acting on behalf of The Treehouse from any claims made as a result of my actions. This release shall be effective and binding upon the parties, as well as their heirs, beneficiaries, assigns, successors and legal representatives. By checking the box, I acknowledge having read and understood this release. *

By checking the box, I acknowledge that I have read and understand this release.

Electronic Signature *

By entering your name below, you agree to the conditions set forth in this form.

First Name

Last Name