Student Enrollment Application"*" indicates required fieldsStep 1 of 1010%Student InformationName* First Middle Last Grade The Student is Entering*Please Select GradeKindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth GradeSixth GradeSeventh GradeEight GradeNinth GradeTenth GradeEleventh GradeTwelfth GradeSchool Year*Gender* Male FemaleDate of Birth* MM slash DD slash YYYY Student Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell PhoneStudent Email if appicable EthnicityAfrican AmericanCaucasianNative AmericanAsianHispanicOtherPrevious School InformationName of Last School AttendedLast School Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country School PhoneHas Student Been Retained?NoYesIf yes, what grade?Are there special circumstances regarding student health or learning? Please list below:Does student have and IEP?*Please SelectYesNoIF yes, what school district is the IEP through?Will student need bus transportation?Please SelectNoYesIf yes to busing, what school district is this through?Will student need before of after school care?Please SelectNoYesIf yes to before or after school care, please list days and times:Family InformationWho Does the Student Live With?*Please SelectFather & MotherFatherMotherGuardianFather's InformationName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell PhoneWork PhoneFather's Email Father's Work Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Mother's InformationMother's Name First Last Cell PhoneWork PhoneMother's Email Employers Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Guardian InformationGuardian's Name First Last Relationship to the StudentGuardian's Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Guardian's Cell PhoneGuardian's Work PhoneGuardians' Work Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Church InformationStudent/Family ChurchChurch AttendanceRegularInfrequentNo attendanceSiblingsHow many siblings does the student have?*NoneOneTwoThreeFourFiveSixSevenEightSibling #1Sibling One First Last Sibling One's Birthdate MM slash DD slash YYYY Sibling One's current schoolSibling #2Sibling Two First Last Sibling Two's Birthdate MM slash DD slash YYYY Sibling Two's current schoolSibling #3Sibling Three First Last Sibling Three's Birthdate MM slash DD slash YYYY Sibling Three's current schoolSibling #4Sibling Four First Last Sibling Four's Birthdate MM slash DD slash YYYY Sibling Four's current schoolSibling #5Sibling Five First Last Sibling Five's Birthdate MM slash DD slash YYYY Sibling Five's current schoolSibling #6Sibling Six First Last Sibling Six's Birthdate MM slash DD slash YYYY Sibling Six's current schoolSibling #7Sibling Seven First Last Sibling Seven's Birthdate MM slash DD slash YYYY Sibling Seven's current schoolSibling #8Sibling Eight First Last Sibling Eight's Birthdate MM slash DD slash YYYY Sibling Eight's current schoolPreferred Emergency Phone NumberReferred to CCA BY:Grandparents Information (Please fill this out to assist us in planning our yearly Grandparent's Day at CCA)How many grandparents does the student have?*NoneOneTwoThreeFourGrandparent #1Grandparent One First Last Grandparent One Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Grandparent One PhoneGrandparent One Email Grandparent #2Grandparent two First Last Grandparent two address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Grandparent two phone numberGrandparent two Email Grandparent #3Grandparent three First Last Grandparent three Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Grandparent three PhoneGrandparent three Email Grandparent #4Grandparent four Name First Last Grandparent four Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Grandparent four PhoneGrandparent four Email Emergency InformationStudents Doctor First Last Doctor's PhoneStudent's Dentist First Last Dentist's PhoneMedical Insurance CompanyMember ID/GroupPolicy NumberPreferred HospitalPermission To Treat*YesNoList any ongoing medications and dosages your child takes:List any heath issues your child may have-i.e. seizures, diabetes, food allergies, asthma, etc.Emergency Contacts-please list two responsible adults who will assume responsibilty for your child in an emergency if parents/guardians cannot be reached (must be someone other than parent/guardian)Emergency Contact #1* First Last RelationshipCell PhoneEmergency Contact #2* First Last RelationshipCell PhoneStudent Pick up Information- The following individuals have permission to pick up my child from school.Name First Last RelationshipPhoneThey may pick up under the following:*Any timeAt my requestName First Last RelationshipPhoneThey may pick up under the following:*Any timeAt my requestParental Responsibility StatementParent Responsibility Statement I agree to the following:I am in agreement with the mission and purposes of Crawford Christian Academy and wish to have my children educated accordingly.The school reserves the right to place my child at the appropriate grade level.The school reserves the right to dismiss any student who does not cooperate or who interferes with the educational process.I will support the policies and procedures of CCA as they are stated in the Student/Parent Handbook.I agree to pay all tuition, fees and other financial obligations to CCA on the established contracted day.If I become dissatisfied with the school in any respect, I will seek to resolve the matter with the appropriate persons involved rather than spreading criticism or holding negative attitudes in my heart.If it is determined that information given in this application is inaccurate or incomplete, then the administration reserves the right to dismiss my child.By Typing Your Name Below you agree to the Parental Responsibility Statement-Parent or Guardian One*By Typing Your Name Below you agree to the Parental Responsibility Statement-Parent or Guardian Two*Biblical-Morality StatementBiblical Morality Statment* I agree with the Biblical Morality StatementCrawford Christian Academy (CCA) is a uniquely religious, educational institution that seeks to provide a quality education in a distinctly Christian environment. One of the goals of CCA is to work with parents and guardians to train Christian young men and women to be salt and light in their communities. CCA believes that the Bible is the inspired Word of God and sets forth absolute truth by which Christians are to live. CCA expects and requires that both students and parents will support the school in its distinct mission and in its biblical beliefs. In relying on the teachings of Scripture, CCA believes that the Bible prohibits sexual immorality of any type, including but not limited to pornography, homosexuality, or any other sexual activity outside the marriage of one man and one woman. On those occasions in which a particular home or student is acting counter to or in opposition to the biblical beliefs and lifestyles that the school teaches, the school reserves the right, in its sole discretion, to refuse admission to an applicant or to discontinue enrollment of a current student. This includes but not limited to , living in, condoning, or supporting any form of sexual immorality; practicing or promotion of a homosexual lifestyle or alternative gender identity; or otherwise having the inability to support the moral principles of the school stated in the handbook. I have read and understand the school's Biblical -Morality Statement.By typing your name below you agree to the CCA Biblical and Morality Statement- Parent/Guardian OneBy typing your name below you agree to the CCA Biblical and Morality Statement- Parent/Guardian TwoStatement of Faith* I agree to the Statement of Faith∙ WE BELIEVE one God eternally exists in three persons: Father, Son, and Holy Spirit (John 1:1; Acts 5:3-4; Matthew 3:16, 28:18, 20) ∙ WE BELIEVE the deity and virgin birth of Jesus Christ (Luke 1:30-35) ∙ WE BELIEVE the Creation and subsequent fall of man (Romans 3:10-12, 23; 5:12) ∙ WE BELIEVE the redemptive work of Christ: His efficacious blood, His death, His burial, bodily resurrection, and ascension (Mark 15:15 – 16:20; Romans 3:24-25) ∙ WE BELIEVE all who receive by faith alone the Lord Jesus Christ are born again of the Holy Spirit and thereby become children of God (Romans 10:9-10; John 1:12-13; Ephesians 2:1) ∙ WE BELIEVE the local church was established by Jesus Christ and entrance is based on a public confession of faith and water baptism by immersion (Acts 2:41-47) ∙ WE BELIEVE the second coming: the pretribulation rapture of the church and the premillennial return of Christ (I Thessalonians 4:13-18; Matthew 24:29-30) ∙ WE BELIEVE the bodily resurrection of the just and unjust: the everlasting blessedness of the saved and the everlasting, conscious punishment of the lost (Revelation 20:13-15) ∙ WE BELIEVE God has ordained the family as the foundational institution of human society. It is composed of persons related to one another by marriage, blood, or adoption. Marriage is the uniting of one man and one woman in covenant commitment for a lifetime. (Genesis 2:18-25) It is God’s unique gift to reveal the union between Christ and His church and to provide for the man and the woman in marriage the framework for intimate companionship, the channel of sexual expression according to biblical standards, and the means for procreation of the human race. (I Corinthians 6:18, 7:2-5; Hebrews 13:4) ∙ WE BELIEVE that God wonderfully foreordained and immutably created each person as either male or female in conformity with their biological sex. These two distinct yet complementary genders together reflect the image and nature of God (Genesis 1:26-27). Rejection of one’s biological sex is a rejection of the image of God within that person. ∙ WE BELIEVE the verbal plenary inspiration and inerrancy of Scripture (II Timothy 3:16) Our Statement of Faith is not exhaustive of all of our beliefs. The Bible, as the inspired and infallible Word of God, speaks with absolute authority regarding the proper conduct of mankind as is the unchanging foundation for all belief and behavior. I have read and understand the above Statement of Faith of Crawford Christian AcademBy typing your name in the line below you agree to the CCA statement of faith- Parent/Guardian OneBy typing your name in the line below you agree to the CCA statement of faith- Parent/Guardian TwoPhoto Release -I hereby grant permission for CCA to photograph my son/daughter for possible use in promotional materials. In addition, I grant CCA, its employees and staff, the irrevocable right and license to use the likeness of my son/daughter on photographs; to crop such photographs at their discretion; to incorporate such photographs in promotional projects at their discretion; and to use such photographs or any portion thereof in any manner, including posting on the CCA website as a part of, or connected with any promotional materials. I agree to hold CCA, its employees and staff, harmless against any liability, loss or damage resulting from the use of my child’s likeness, and I hereby release and discharge any claims whatsoever in connection with such use of my child’s likeness in the above projects. I am signing this release freely and voluntarily, and I am not relying on any inducements, promises, or representations made by CCA. This photo release will be in effect as long as my child is attending CCA* Yes, picture may be used on social media sites and school website Yes, picture, but NO name attached with it. No picture or Name listed on social media sites, newsprint, with one exception for yearbook entries Other, we give specific instructions to CCA regarding the photo release of our childCommentsThis field is for validation purposes and should be left unchanged.Δ
