PARENTS / LEGAL GUARDIAN INFORMATION
Emergency Contact - Other then parent/Guardian
By signing below, I certify that all information in this form is correct. and i agree to the waivers below.
I give legal authorization for the Friendship Circle of Cleveland to use some or all of the information in this form to the best of their ability to secure and provide a healthy enviorment for my child when they are in their care.
I release the Friendship Circle, its providers and administrators, from ALL liability for any incident which affects the health, welfare, or safety of my child in the provision of a Friendship Circle program for the year 2018/2019.
In the event that I hire a volunteer for my personal babysitting, I release Friendship Circle from any responsibility.