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Liability Release Form

indicates a required answer

1. *

Full name of Child Attending:

2. *

Parent Name: 

I agree that West Shore Christian Educational Community and Christian Life Assembly shall bear no liability in the event of an accident or injury, and that all actions and intentions involving this co-op are benevolent. 

3. *

Please initial that you agree with the above statement. 

4. *

Your email address will serve as your signiture on this form.