Christmas Bazaar sign up and liability release form
I give permission to my below named son/daughter to attend the event listed below when I submit this form. (Please submit a form for each child attending.)

If needed for health reasons, I give my permission for my child to be evaluated, diagnosed, treated and/or given medication in accordance with standard medical practice by licensed medical personnel. I relieve Epiphany Parish at St. Joseph the Worker liable in the event of injury. Further, I agree to accept any and all financial responsibility as a result for scheduling medical treatment.

My child agrees to abide by all the rules and regulations given by the group organizer of Epiphany Parish at St. Joseph the Worker. I understand that Epiphany Parish at St. Joseph the Worker will not be liable if my child fails to cooperate with regulations and that any infraction of the rules may result in immediate dismissal from the event.
Christmas Bazaar ~ Sign up by December 1, 2019
Epiphany Parish at St. Joseph the Worker Parish Center
December 7, 2019 from 10:00 a.m. – 1:30 p.m.
Lunch will be served.
Children ages 4 to 12 are welcome to come and select Christmas gifts for their parents and grandparents.
All gifts are $1.00 each.
Activities include: shopping, wrapping, crafts, coloring, movies, and cookie decorating.

• Bazaar is for children ages 4-12 from Epiphany Parish
• Gifts for adults
• Remember gifts are $1.00 each
• Parents must come in and drop children off
• Please pick up children promptly at 1:30 p.m.
• ID is required when picking up children
• Register by December 1, 2019
• For more information, call 315-457-6060
Last Name of Child *
Your answer
First Name of Child *
Your answer
Parent/Guardian name *
Your answer
Phone # *
Your answer
Emergency contact *
Your answer
Emergency phone # *
Your answer
Allergies *
Your answer
Please indicate how many gifts and for who the gift is for. *
Your answer
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