Request Membership

Fill out the form below and click the Continue button at the bottom.

All registration is now online. Once your registration has been finalized, and your annual Membership Fee received ($15.00 before or on June 30th of 2014-2015 school year or $20.00 on or after July 1st of 2014-2015 school year), you will receive an email inviting you to log in to the CHESCO Website.  Payment for Membership Fees is through PayPal at the end of the following online registration form.  If you wish to mail a check instead, our mailing address is 1405 4th Ave. NW, PMB 201, Ardmore, OK  73401. Please be aware that payment must be received and all forms filled out completely before access to the website can be given.   Thank you! 

 

 

***IMPORTANT***Agreement to the online forms will serve as your digital signature, so please read carefully before signing each section.

Check here if you have read and agree to the TERMS OF SERVICE.

* indicates a required field
*Last Name:
*Primary First Name:
Spouse First Name:
*Address:
*City:
*State/Country:
For United States and Canada:
For Other Countries:
State/Province:
Country:
*Zip/Postal Code:
* Timezone:
*Area Code:
*Phone:
Phone 2:
Fax:
*Email:
Additional Email Address(es):
Separate multiples with a comma.
If additional email address(es) are entered above, should they also receive weekly email and forum notifications, etc.?
Yes     No
Children:
Show Children Info to Other Families:
*User Name: (must be 3-15 characters long)
*Password: (must be 3-15 characters long)
*Confirm Password:
 
Church Affiliation:
Curriculum/Teaching Style:
Year you Started Homeschooling:
Family Business/Services:
*Weekly Email Update: Would you like to receive a weekly email update?
Yes    No
 
*Privacy: Include my family information in the membership on-line directory?
Yes    No
 
*Forum Emails: Would you like to receive forum notifications via email (not just the ones you create)?
Yes    No
Many Emails: Would you like to receive notifications IMMEDIATELY?
Yes      No
Delivery Type:
Whole Thread      New Part Only
Daily Digest: Would you like to receive notifications ONCE A DAY?
Yes      No
Classifieds - Many Emails: Would you like to receive ALL classified notifications IMMEDIATELY via email:
Yes    No
Classifieds - Daily Digest: Would you like to receive ALL classified notifications ONCE A DAY via email?
Yes    No
Message to Group Administrator:

Additional Questions:

1.

Family/Child(ren)'s Interests:

Please include here any special interests of your child(ren) or family so that others may get to know your family better.

***IMPORTANT***Agreement to the online forms will serve as your digital signature, so please read carefully before signing each section.

2. *

SERVICE TO THE GROUP:

 

As a condition of membership, each CHESCO Member Family agrees to provide one service to the group per year.  This service may be in the form of an organized activity, event, field trip, Enrichment Class, Moms' Night Out, and so on. 

Services performed by members must be organized through CHESCO Coordinators or through the Enrichment Administrators.

Member families who fail to provide the agreed upon one service per year will be allowed a conditional membership for the following year, provided that they provide their service to the group before December 30th of that school year.  Members who fail to provide this service will have their membership suspended on January 1st.

Your digital signature below serves as an acknowledgment of this policy.

3. *

STATEMENT OF FAITH/CONDUCT GUIDELINES:

 

CHESCO Membership Statement of Faith

and Conduct Guidelines
 

Statement of Faith:


While we all come from different backgrounds and walks of life, we agree on these central truths:


1. We believe the Bible to be the inspired word of God, infallible and the supreme and final authority for all faith and life.


2. We believe that there is one God, eternally existent in three persons: Father, Son, and Holy Spirit.


3. We believe in the virgin birth and sinless life, literal death, and bodily resurrection of Jesus Christ.


4. We believe that mankind is lost without hope and doomed to eternal destruction without salvation, and that salvation is obtained only by grace through faith in the shedding of Jesus Christ’s blood for the atonement and remission of our sins.


Conduct Guidelines:


When representing CHESCO at meetings, field trips, and other group planned activities, I will do my best to:
1. Be prompt.
2. Be courteous.
3. Be responsible for my child(ren)’s actions and behavior.
4. Show proper behavior – i.e., respect, low voices, raising of hands, etc., when necessary.
5. Show appreciation by thanking the planner, guide, coordinator, etc.


I have read, do understand the CHESCO Statement of Faith, and will abide by the above conduct guidelines. I am also aware that with membership to CHESCO comes my agreement to provide one service to the group per year (i.e., coordinating of a fieldtrip, teaching co-op class, planning of mothers’ night out event, etc.) as written in the CHESCO By-Laws Article II: B-5.

Revised 4/15/2012

Your digital signature below serves as an acknowledgment of the above Statement of Faith/Conduct Guidelines.

 

 

4. *

MEDICAL/LIABILITY RELEASE - CHILD(REN):

As stated in the CHESCO Code of Conduct, it is understood by me, the below-named child(ren)'s parent/legal guardian, that all classes, field trips, etc, have requirements for parental involvement. However, depending on the age of the student, I might not be required to be present at all times. In the event of a medical emergency when I am not present, this form will serve as my permission to seek medical treatment for the above-named student.


The student(s) named below has or have permission to attend CHESCO activities, and his/her/their health history listed below is correct as far as I know. In my absence, I hereby give permission to CHESCO to transport my child(ren) for the purpose of medical care as deemed necessary. I hereby authorize medical professionals to provide and secure treatment for all health issues that arise when I am not present and cannot be located. In the event I cannot be reached in an emergency, I give permission to the physician selected to hospitalize, secure proper treatment for, and to order injection, anesthetic, or surgery for the student named above. I hereby authorize the executive staff or designated professionals to dispense over-the-counter medications as needed to the student listed above.


I also agree to release liability and hold harmless CHESCO members, Board of Officers and any facilities used for school, field trips and any other CHESCO activities while my student(s) listed below is or are participating.

Please list below each child's name:

5. *

HEALTH HISTORY/ALLERGIES/MEDICATIONS:

Please list here, with the name of each child concerned, any known allergies, current medication or other applicable health information:

6. *

Emergency Phone #1:

7. *

Emergency Phone #2:

8. *

Emergency Phone #3:

9. *

Primary Physician:

10. *

Physician Phone Number:

11. *

Hospital Preference:

12. *

SIGNATURE OF MEDICAL/LIABILITY RELEASE - CHILD(REN):

By my digital signature below, I confirm that I have reviewed all information in Sections 4 through 11 and that all information is correct.

 

13. *

DATE OF SIGNATURE:

Signatures and Dates must be current for the current school year.  Please indicate the date of your signature below.

14. *

Medical/Liability Release - Adult:

I hereby agree to release liability and hold harmless CHESCO members, Board of Officers and any facilities used for school, field trips, and any other CHESCO activities while I am participating.

Your digital signature below serves as an acknowledgment of the above statement.

 

15. *

DATE OF SIGNATURE OF MEDICAL/LIABILITY RELEASE - ADULT :

Forms must be signed each year.  Please provide the current date.

16. *

PUBLICITY RELEASE FORM:


From time to time during CHESCO activities or events, participants will be photographed, videotaped, or interviewed.


These photographs, videos and interviews may be used for the promotion of CHESCO through promotional brochures, CHESCO's Facebook page, newspaper articles/photographs, and our website. Images of and statements by your child/family may be used.


Since it is difficult to gather permission after the fact, all participants must have a signed release on file. Thank you for your cooperation in this matter.


I, the undersigned, do hereby grant to CHESCO the right to use my child/family's photograph, and/or video footage, etc.


I, the undersigned, understand that release and consent given herein, is made without compensation,
and no compensation is required or anticipated. I hereby release CHESCO from any and all liability, claims, or causes of action with this consent and release.


Your digital signature below serves as an acknowledgment of the above statementsThe following box will allow you to enter the names of family members with your "yes" or "no" permission.

 

17. *

PUBLICITY RELEASE - NAMES OF CHILDREN AND ADULTS:

In the box below, please indicate that permission is given or not given for the children and adults in your family.  Please list each member of your family with a "yes" for permission given or a "no" for no permission given.

18. *

SERVICE TO THE GROUP FULFILLMENT:

All member families of CHESCO agree to fulfill one service to the group per school year.  If you are a current CHESCO member, please sign below that you have fulfilled your service to the group for the current school year, or please indicate to the group administrator that you have not yet fulfilled the service requirement.  The service requirement must be fulfilled before a member family is able to enroll for Enrichment.  In addition, if the service requirement has not been fulfilled by June 30th of the current school year, the member family is required to fulfill that service by December 30th of the following school year.   A family's membership will be suspended on January 1st if the previous year's service has not been fulfilled by December 30th. Please make every effort to keep CHESCO strong by fulfilling your service to the group requirement.

 

If you are just joining CHESCO, please sign below that you are familiar with our annual service to the group requirement.

Type in the text that you see above: