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Drop 'N Shop Registration Form

  1. Who to contact should we not be able to get a hold of the primary listed parent.

  2. Does your child have any food allergies?*
  3. Does your child have any medical conditions to be aware of?*
  4. I, the parent/guardian of the above named participant hereby grant permission for the use of my child’s image and appearance in photography and video for official Harmony Master HOA and CCMC publicity including but not limited to website, publications, displays or presentations. *
  5. I, the parent/guardian of the above-named participant(s), am eighteen years of age or older and have volunteered my child to participate in the Harmony Master Homeowners Association events and activities. I agree to assume all risks for my child’s participation in these activities and agree to release, hold harmless and indemnify Harmony Master Homeowners Association, Capital Consultants Management Corporation, and its employees, volunteers and representatives for any injury that may result from such participation.*
  6. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  7. Leave This Blank:

  8. This field is not part of the form submission.