Digital RELEASE OF LIABILITY and Medical Form Redeemer Lutheran Church: Rochester, MN. - Form for Minors
CAUTION:  THIS IS A RELEASE-READ CAREFULLY BEFORE SUBMITTING
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I realize that this form is valid for 1 year from submission *
Name of Child Participant *
Address (City, State, Zip) *
Participant Phone Number *
Participant email *
Print the names of parent(s) and/or legal guardian(s). *
Guest of: (if youth is not a member of Redeemer)
Age of Participant *
Birth Date *
MM
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DD
/
YYYY
Academic Grade (2021-2022) *
School
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