Register for Reading Success - West Nashville

I authorize Be About Change (“the Organization”), a non-profit organization and/or its agents, to instruct the student named above in age-appropriate physical training (as applicable to program) and classroom instruction.

For programs with fitness components, we strongly encourage you secure the student’s physician's approval before beginning this or any other exercise program. Consult the student’s doctor, nutritionist, and/or dietician for further information.

Student Records
I authorize the release of records, including but not limited to Be About Change partners (current and future), school, court, agency, and/or other organization records to Be About Change and/or its agents, and authorize applicable personnel from these agencies to discuss with Be About Change, topics including, but not limited to, academic performance, attendance, and/or conduct.

Indemnification
I agree to hold harmless and indemnify Be About Change, and/or any of its agents, against any and all claims and actions arising out of the student’s participation in the activity, including, without limitation, expenses, judgments, fines, settlements, and other amounts actually and reasonably incurred in connection with any liability, suit, action, loss, or damage arising or resulting from the organization’s participation in the activity. Where prohibited by law, the above indemnification does not include indemnification of the of the organization against a claim caused by the negligence or fault of the organization, its agents, or any third party under the control or supervision of the organization, other than the parent or student or its agent, employee, or subcontractors.