2022 Fall Harvest Fest Registration Form

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Activity Event: FALL HARVEST FESTIVAL Date: OCTOBER 29, 2022
Coordinator: Rock City Church Time: 12:00 p.m. – 4:00 pm
Telephone: (410) 882-0807 Location: 1607 Cromwell Bridge Rd. (21234)
Description of Activity: Games, hayride, horses, inflatables, food, contests, and activities.

Participant(s) Full Name(s) *

Participant(s) Ages(s) *

Parent/Guardian(s) Last Name *

Parent/Guardian(s) First Name *

Parent/Guardian(s) Email Address *

Parent/Guardian(s) Phone Number *

Parent/Guardian(s) Mailing Address *

Emergency Contact's Name (Other than Parent/Guardian) *

Emergency Contact's Phone Number *

Liability Statement: As the parent/legal guardian of the above-named minor(s), I give my permission for the above-named participants to participate in any and all activities, events, and programs at the Fall Harvest Fest on the grounds of Rock City Church. In the event of a medical emergency, I authorize a representative of Rock City Church to transport me or my child to the nearest medical facility for treatment or call 911. By signing below, the participant (or parent/guardian, if the participant is a minor) acknowledges and accepts the risk of physical injury or illness associated with participation in the activities described above. I accept personal financial responsibility for any bodily or personal injury or illness sustained during this event. Further, the participant (or parent/ guardian) promises to hold harmless event vendors, Rock City Church, and its representatives for any illness, injuries or accidents. I understand that I am responsible for all legal fees should I take legal action against any event vendor, Rock City Church, or any event volunteers or representatives. I understand that event tickets purchased are not refundable for any reason. I also understand that my families’ photographs may appear in print, digital, video, or online event promotional materials. By typing my name below, I understand and agree to the statements listed above. *

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