Feb 22/23- Please arrive at Mt. Vernon Church by 7:00pm. If you are staying for the entire lock-in pick up is 8:00am.
Youth Name *
Your answer
Parent/Guardian Name *
Your answer
Emergency Contact Name/Number *
Your answer
Church affiliation *
How much of the Lock-in will your child be attending? *
In case of Emergency: I understand that every effort will be made to contact me. If I cannot be reached, I hereby give LEBANON CHURCH/Mt Vernon Church permission to act on my behalf in seeking emergency treatment for my child in the event that such treatment is deemed necessary by LEBANON CHURCH/Mt Vernon Church. I absolve LEBANON CHURCH/Mt Vernon Church from liability in acting on my behalf in this regard so long as LEBANON CHURCH/Mt Vernon Church is not grossly negligent. I also allow Lebanon Student Ministry/Mt Vernon Church to use my students image in photos and videos. *
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