Student Sign-Up

To become a student:
1) Fill out the application 2) Upload your photo ID
3) Pay $20 semester fee by clicking the button below

For assistance, please contact us at 901-726-5902 or deneuvillecenter@gmail.com

Once we receive your application we will contact you.

    NewReturning

    African decent/BlackAmerican IndianAsian/Pacific IslanderHispanic origin/LatinaMiddle Eastern/ArabicWhite (not of Hispanic origin)Other

    Never married (single)Legally marriedLiving as married (common law marriage)SeparatedDivorcedWidowed

    ESL (English as a Second Language)HiSet/GED in EnglishHiSet/GED in SpanishComputer StudiesCitizenship Test Preparation

    MorningEvening

    yesno

    yesno

    Less than $10,000$10,000-$20,000$20,001-$30,000More than $30,000

    Full timePart timeSelf-employedUnemployedRetired

    In consideration of being allowed to participate in any way in the program, related events and

    activities, I the undersigned, acknowledge, appreciate, and agree that:

    1. The risk of any injury from the activities involved in the program or using any exercise

    equipment.

    2. I knowingly and freely assume all such risks, both known and unknown and assume full

    responsibility for my participation.

    3. I willingly agree to comply with the policies presented to me at admission. If I observe any

    unusual significant hazard during my presence or participation, I will remove myself from

    participation and bring such to the attention of the director/staff/volunteer immediately.

    4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin,

    hereby release, indemnify, and hold harmless its officers, officials, program directors,

    agents and/or employees, other participants, sponsors, advertisers, and if applicable,

    owners from any and all claims, demands, losses, and liability arising out of or related to

    any injury, disability or death I may suffer, or loss or damage to person or property to the

    fullest extent permitted by law.

    I have read this release of liability, fully understand its terms and sign it freely and

    voluntarily without any inducement.