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THE SALVATION ARMY OF
MARIETTA HOMESCHOOL CO-OP
Registration Form
The Salvation Army
136 Front Street
Marietta, OH 45750
wanessa.moore@use.salvationarmy.org
THE SALVATION ARMY OF MARIETTA HOMESCHOOL CO-OP
FAMILY APPLICATION AND INFORMATION
(Even if you’ve participated in Co-op before, we need a form filled out for every Co-op session.)
LAST NAME:
FATHER:
MOTHER:
.
ADDRESS:
.
CITY, STATE, ZIP:
.
PHONE:
PARENT’S E-MAIL:
.
NAME, BIRTH DATE, GRADE AND AGE OF CHILDREN:
/
/
GR
AGE _____
/
/
GR
AGE _____
/
/
GR
AGE _____
/
/
GR
AGE _____
/
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GR
AGE _____
EMERGENCY CONTACT
PHONE _________________
DO ANY OF YOUR CHILDREN HAVE ANY ALLERGIES WE SHOULD BE AWARE OF?
_________________________________________________________________________________
HOW LONG HAVE YOU HOMESCHOOLED? _________________________________________
NAME OF PARENT WHO WILL ATTEND CO-OP?
.
EACH ATTENDING PARENT WILL BE ASSIGNED TWO VOLUNTEER POSITIONS. PLEASE INDICATE ANY
PREFERENCES OR STRENGTHS YOU MAY HAVE THAT WILL ASSIST US IN ASSIGNING YOUR POSITIONS.
WE WILL DO OUR BEST TO PLACE YOU WHERE YOU WOULD MOST LIKE TO BE.
.
.
I hereby consent for the child named above to participate in The Salvation Army of Marietta
Homeschool Co-op. I hereby irrevocably grant to The Salvation Army the absolute right and
permission to copyright and/or publish or use photographic portraits or pictures of my child, or in
which he or she may be included in whole or in part, or composite or distorted in character or form, in
conjunction with my name or a fictitious name, or reproductions thereof in color or otherwise, made
through any media, for art, advertising, or any other lawful purpose whatsoever. I also grant The
Salvation Army the same right and permission to use any statements or testimonials made by me.
Date: ______________________________________________
Name (Printed):______________________________________
Signature: __________________________________________
THE SALVATION ARMY OF MARIETTA HOMESCHOOL CO-OP
STUDENT AGREEMENT
All students enrolled in The Salvation Army Co-op must adhere to the following guidelines:
Be honest, courteous and patient with everyone; treating others with Christ-like kindness.
Respect and obey those in authority.
Dress Modestly and avoid any display of PDA.
Be on time for classes (this means arriving before class begins).
Use respectful and polite language.
Remain with your class unless you obtain permission from your teacher to leave and be in
the appropriate areas at all times; not roaming the building or property.
Do not bring electronic devices of any kind to classes (music, gameboys, etc). Do not
bring weapons, including pocket-knives, on the property.
Complete homework (if any) given by your instructor and fully participate in class by
engaging with other students and the instructor during class time.
Contact the instructor when you are absent.
Reimburse for any damage done by the student to the facility or equipment.
Please have each child in your family read and sign this.
I have read (or my parent has read to me) and I agree to abide by the above guidelines. Each student only needs
to sign once.
Student signature _________________________________________________________
Student signature _________________________________________________________
Student signature _________________________________________________________
Student signature _________________________________________________________
Student signature _________________________________________________________
Student signature _________________________________________________________
Date ___________________________________________________________________
coop registration.pdf (PDF, 120.71 KB)
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