Lock-in Permission Form
Join us for our end of the summer 2022 Summer Lock-in! For rising 7th-12 graders!

1) By filling out this form you are giving permission to allow your child to join our Lock-in
2) By filling out this form you are agreeing that you the Parent/Guardian "I give the church permission to retain the information given here in its records and to update the church if there is any change. The church is hereby given authorization and permission to furnish any necessary transportation, food and lodging for the Participant in connection with the named activity. I understand that, in the event a medical intervention is needed for the Participant, reasonable attempts will be made to immediately contact me. In the event that I or the alternate contact cannot be reached, I hereby give my permission to secure medical treatment for the Participant as necessary, including but not limited to emergency surgery or treatment, and I will assume the responsibility of all medical bills, if any. Should it be necessary for the Participant to return home due to medical reasons, disciplinary action or otherwise, I hereby assume all transportation costs. I and on behalf of the Participant, hereby assume all risk of personal injury, sickness, death, losses, damage and expenses of any nature whatsoever which may be incurred by the undersigned and the Participant while participating in the above event, and any work, activities and recreation involved therein; and agreed to hold the Church, its officers, staff, co-workers, and volunteers harmless, and release and forever discharge them from any and all liabilities, claims or demands in connection therewith. I hereby also further agree to hold harmless and indemnify the Church, its officers, staff, co-workers and volunteers for any and all liabilities sustained by the church as a result of negligent, willful or intentional acts of the Participant, including expenses incurred in connection therewith. By signing below, I acknowledge that I have read and understand of the above and that I accept the conditions contained herein. I also represent with signature below that by signing on behalf of the named Participant, I am the parent/legal guardian of the Participant."

* Please note that there may be an optional movie this evening, pg-13 rating. By signing this, you are also agreeing to let your child watch said movie. (undecided movie at the moment)

*All Students coming to the Lock-in must take a covid test (rapid test) 3 days before and the day of the lock-in (do no come if positive) 

Event name: LYF Lock-in

Location: CBCGL

Date (and time): Friday August 26, 10pm - Saturday April 27, 7:30am

Cost: None

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What is the name of your child *
Primary Contact In case of emergency (name, number, and relation to Student) *
Alternate Contact In case of emergency (name, number, and relation to Student) *
Physician's Contact In case of emergency (name, number) *
Participant's  medical insure provider:
(Primary Insured's name and Insurance policy number)
I plan on Joining the Morning community service Sat 24

(Pick up at 12pm at church)
Parents, would you like to join your kids in community service? If so please us at church 7am! we will leave around 7:30!  OR you can join us at the service site! Please contact Deacon Charles or Yajwu for details
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