Mother Cell Phone:
State child(ren)'s name and condition, if applicable
List Medication to be administered (if needed).
Medical Protocol to follow should a problem arise (please include symptoms to look for as well as treatment plan you would like us to follow, complete with who to contact)
RELEASE OF LIABILITY AND GENERAL AGREEMENT - FAMILY MEMBERS: Please list first and last name of each family member who is likely to come on campus - i.e. parent, legal guardian, each child in the family (even those not attending Co-op) and extended family)
(hereinafter referred to as "Family") in consideration of being permitted to participate in The Upstate Homeschool Co-op, agree to the Release of Liability and General Agreement (agree at bottom).
TYPE OF FAMILY: Please select the type of Family you represent:
HOMESCHOOL ACCOUNTABILITY: Under which South Carolina Homeschool option are you legally registered to homeschool?
GRADE LEVEL: The student(s) I am registering are taking classes in the following grade level(s) OR I am teaching class(es) at co-op in the following grade level(s):
REFERENCES: Acceptance into UHC is contingent upon follow-up of references. You must have a pastor, church leader, or current Upstate Homeschool Co-op member complete this and sign. It must be emailed by the reference to an Administrator prior to registration day. Instructions are in the form. Referral Letter
DIGITALLY SIGN FORMS: Agreement to the online forms below will serve as your "digital signature", so please read carefully before agreeing at the bottom. Since you are filling out Registration Forms online, it will NOT be necessary to print these forms.
I hereby affirm the
Statement of Faith I have read the
Volunteer Agreement and agree to fulfill my service responsibility I have read, accept, and will abide by the
Financial Agreement. I hereby authorize Upstate Homeschool Co-op to seek medical attention for my child(ren) should the need arise.
I hereby release Upstate Homeschool Co-op from all liability to my family for any loss or damage as set forth in the
Release of Liability Agreement. I will read the
Elementary and/or Middle School Student/Parent Contract and I agree that I will oversee my student and help him/her keep the terms, conditions, and privileges described therein. My High School-age students will read and will comply with the terms of the
High School Handbook, and will sign the student contract when asked to do so.
Spouse is in agreement:
By checking the box below, I acknowledge that registration is not official until I have attended an on-site registration day, registered for individual classes there, signed up for volunteer hours, and financial payment has been received.