Student Information
Parent/Guardian Information
Emergency Contact Information
I hereby release and agree to indemnify, defend, and hold harmless the Concordia Learning Center, its representatives, agents, and directors from all claims or liability for damages and/or injuries incurred by my
children in connection with after-school, summer or Saturday services provided at The Concordia Learning Center. I understand that the Center does not provide insurance coverage for accidents or injury sustained by my child. I agree that use of the center provided at the Concordia Learning Center and participation in activities or events at the Center shall be undertaken by my child at his or her sole risk, and the Learning Center shall not be liable for any injuries or any damage to my child, or be subject to any claim, demand, injury or damages whatsoever, irrespective of cause or origin. The Learning Center shall not be responsible or liable for articles damaged, lost, or stolen, in or about theCenter. I HEREBY ATTEST THAT I HAVE READ AND UNDERSTAND THE ABOVE DISCLAIMER GOVERNING SERVICES AT THE CONCORDIA LEARNING CENTER.