Interfaith Youth Service
Temple Israel 
91 Springside Dr. 
Akron, OH 44333
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Child's Name  *
Emergency Contact Name *
Emergency Contact Number *
I give permission for my child/charge to be transported in a motor vehicle driven by a licensed adult to the event specified above.  The child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the drivers and/or other adult volunteers.  I understand that participation in the identified event is not required. I recognize that by participating in this activity, my child may risk personal injury or permanent loss.  I verify that I am aware of the potential risks involved in this activity, and that I assume any expenses that may be incurred in the event of an accident, illness or other incapacity; regardless of whether I have authorized such expenses.  As a condition for the transportation received, I agree to release and forever discharge The Church in Aurora and their employees and volunteers from any claim that I might have myself or that I could bring on my child's behalf with regard to any damages, demands or actions whatsoever, in any manner arising out of this transportation and event.  I have read this entire waiver and permission form and fully understand it. 

By typing my name below I signify my understanding. 
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