2019 Fall Harvest Fest Registration Form
Activity Event: FALL HARVEST FESTIVAL Date: OCTOBER 26, 2019
Coordinator: Rock City Church Time: 1:00 p.m. – 4:00 pm
Telephone: (410) 882-2217 Location: 1607 Cromwell Bridge Rd. (21234)
Description of Activity: Games, hayride, horses, inflatables, food, contests, and activities.
Participant(s) Full Name(s) *
Your answer
Participant(s) Ages(s) *
Your answer
Parent/Guardian(s) Last Name *
Your answer
Parent/Guardian(s) First Name *
Your answer
Parent/Guardian(s) Email Address *
Your answer
Parent/Guardian(s) Phone Number *
Your answer
Parent/Guardian(s) Mailing Address *
Your answer
Emergency Contact's Name (Other than Parent/Guardian) *
Your answer
Emergency Contact's Phone Number *
Your answer
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 or Camp Rock. In the event of a medical emergency, I authorize a representative of Camp Rock or Rock City Church to transport 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 associated with participation in the activities described above. I accept personal financial responsibility for any bodily or personal injury sustained during this event. Further, the participant (or parent/ guardian) promises to hold harmless event vendors, Camp Rock, Rock City Church, and its representatives for any 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, Camp Rock, or any event 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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