Beginnings Care For Life  Center, 213 Marshall St, Coldwater, MI  49036 517-278-3355
         
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Men's Frat Reg form

                                                             Beginnings Care for Life Center

                                Men's Fraternity 
                                             Registration Form

Date:____________________

Name:_____________________________________Phone:______________

Address:_________________________City:_______________Zip:________

E-Mail:________________________

How did you find out about this series?

______________________________________________________________



I hereby acknowledge that I am participating in the Men's fraternity series voluntarily. I understand that it is Christian-based.  Beginnings Care For Life Center (BCFLC) does not necessarily condone or recommend all o fthe information and practices presented by the materials included in Men's Fraternity and will not be held liable for any problems associated with the information or ideas suggested by these materials.

I agree to Waive, Release and Hold Harmless BCFLC, their agents, officers, directors and affiliates for any and all present and future claims that I might have or which may accrue, for harm done as a result of any negligence of any of them.

I give permission for BCFLC to use pictures of me, taken during the Men's Fraternity series, for the purpose of promoting their organization's  activities and services.


Signature of Participant:

_________________________________________Date:_________________