Bus Signup
Ages to ride our bus are 4yr old and up / Please contact our Bus Director Josh for any questions (317) 515-1896
Parents Name *
Kids Name
Parents Number *
Address *
Additional Info on your child
I, the undersigned parent or legal guardian, hereby consent to, herein referred to as my child, participating in Kids camp or VBS, an event sponsored by Solid Rock Baptist Church, Pendleton, IN. I certify that my child is able to participate in the following activities: riding the bus from home to church building, games, dinner, services. If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them below. In the event an emergency occurs, I may be reached at the telephone number(s) listed above. If I cannot be reached, I hereby authorize Solid Rock Baptist Church, to make emergency medical decisions for my child. If there are any activities I do not want my child to be involved in, I have listed them below. I understand and hereby agree to assume all of the risks which may be encountered on said activity, including activities preliminary and subsequent thereto. I do hereby agree to hold Solid Rock Baptist Church, Pendleton, IN and its volunteers and employees harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property, even injury resulting in death, which my child now has or which may arise in the future in connection with the activity or participation in any other associated activities. I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Indiana, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto, and the terms of this release are contractual and not a mere recital. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy