Formulaire d'inscription

Orange County Accueil

Un zeste d'amitié pour s'intégrer

Fill out the form:


  • Si le nom contient une particule l'inclure ici
  • Yes No

  • Conjoint


  • Si le nom contient une particule l'inclure ici

  • Si different du nom précédent
  • Yes No

  • Adresse


  • Enfants


  • Autorisations

  • J'autorise Orange County Accueil à faire paraître mes coordonnées dans l'annuaire de l'association Je n'autorise pas Orange County Accueil à faire paraître mes coordonnées dans l'annuaire de l'association

  • Vous devez cocher la décharge ci dessous pour que l’inscription puisse être valider

  • I agree to the disclaimer : According to the decision made by the Board of Orange County Accueil, our association wishes to seek legal protection, and has contracted insurance coverage. We ask all our members to please fill in, sign and return the following disclaimer/waiver. This is a routine administrative formality. The information requested is of a very general nature, and will be kept confidential. WE DECLINE EVERY RESPONSIBILITY IN CASE OF ACCIDENT(S) OR INCIDENT(S) WHICH MAY ARISE OR OCCUR DURING ANY OF OUR ACTIVITIES. Acting also as the parent or guardian of minors listed above, do hereby give my authorization and consent to emergency medical and/or dental treatment, including surgery, if necessary, to be rendered in the event I or said minors require medical and/or dental treatment of any kind, while engaged in any activity conducted or sponsored on behalf of Orange County Accueil. I further agree that, in consideration of my child and/or ward’s participation in all Orange County Accueil activities, I hereby release Orange County Accueil, its officers, directors, volunteers (jointly and severally referred to as “Orange County Accueil”) from any and all liability including, but not limited to, medical and other healthcare expenses, for any injury or damage to me, my child or ward, occurring during the time in which I, my child or ward, are participating in Orange County Accueil activities, even if the injury or damage is caused in whole or in part by the negligence, gross negligence or other fault of Orange County Accueil, from any claims by any person or entity, for loss, liability, damage, injuries, costs (including attorneys’ fees) that may result from my own participation, my child’s or ward’s participation in Orange County Accueil activities, even if the injury or damage is caused in whole or in part by negligence, gross negligence, or other fault of Orange County Accueil. It is understood that Orange County Accueil may publish my pictures, and/or that of a member of my family taken during any activity offered by the association in its “Dépêche” and on its web site. I authorize Orange County Accueil to publish my name in the directory of the association, which is made available free of charge to its members. In this regard, we ask you to please acknowledge the following: I hereby acknowledge that I will not use, sell, copy or reproduce the Orange County Accueil directory for commercial purposes.

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