ARCH-Triad

2009-2010 Membership Registration Form

* Family Name:

* Parents' Names:

* Address:

* City:

* Zip Code:

* Home Phone Number:

* Cell Phone Number:

* E-mail Address:

* Parish:

* Curriculum:

Please list all your children and their date of birth. Indicate with an asterisk ( * ) those you Homeschool:

	Name	DOB	Current Grade
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7
Child 8

Please sign and date below to indicate your agreement with the following statements:

*

1) I have read and will work to support the mission and goals of ARCH.

2) I have read and agree to abide by the ARCH Behavior Guidelines. SEE Behavior Guidelines in Member Packet

3) Protecting God's Children (REQUIREMENT).

* All participating ARCH parents or siblings 18+ must have attended an approved Protecting God’s Children (VIRTUS), Diocesan Safe Environment training within the last 5 years. This is a Diocesan requirement.

I am aware of this requirement.

I will do my part to comply with this membership requirement.

Please attach a copy of your Virtus Training Report (from www.virtus.org).

4) RELEASE AND WAIVER:
I hereby release Association of Roman Catholic Homeschoolers and its chapters, officers, members, and volunteers (referred to collectively here as “ARCH”), from any and all liability for damage or injury to my children or myself or to any person or property during the time of my children’s attendance at ARCH activities whether or not such damages were sustained in connection with any ARCH activities. I hereby agree to indemnify and hold harmless ARCH from any claims, including the cost of expenses, arising in connection with injuries or damage sustained by my children or me. I assume full responsibility for my children’s behavior, for personally assuring their supervision during ARCH activities, and for any damage or injury caused by my children’s actions.

* Type your full name as a digital signature:

* Date:

* Indicates Response Required