Happy Birthday Jesus Party!
Saturday, December 7th, 10:00 am-4:00 pm at Mission Liberty Hill Lutheran Church (15725 TX-29, Unit 7).
Mission Liberty Hill Outreach Team will be hosting a mother's day out event for children potty-trained - 5th grade.
Register your child to come for crafts, snacks, and games.
Lunch will be provided from Chick-fil-a.
This is a free event; however, we ask that you bring a slightly-used toy to donate to someone in need.
SPACE IS LIMITED!! Registration will close on Sunday, December 1st.
Child's First Name *
Your answer
Child's Last Name *
Your answer
Does your child have any allergies? If so, what are they? *
Your answer
Grade of Child *
What email address should we use for event correspondence? *
Your answer
Emergency Contact #1 Name (First/Last) *
Your answer
Emergency Contact #1 Relationship to Child *
Your answer
Emergency Contact #1 Phone Number *
Your answer
Emergency Contact #2 Name (First/Last) *
Your answer
Emergency Contact #2 Relationship to Child *
Your answer
Emergency Contact #2 Phone Number *
Your answer
I/We, the undersigned, are the parent(s)/guardian(s) of the above named child and we agree, in taking advantage of this child care services, to release and hold harmless Mission Liberty Hill Lutheran Church from any and all claims, demands, suits, cost, and charges in connection with or arising out of the child care service, including, but not limited to, bodily harm or injury to our child, except only for loss, harms, or injury occasioned by gross negligence or intentional misconduct by Mission Liberty Hill Lutheran Church. I hereby grant permission for Mission Liberty Hill Lutheran Church and its employees or volunteers full authority to take whatever actions they deem necessary regarding my child's health and safety in the event I cannot be reached or in the situation where time is of the essence; and fully release Mission Liberty Hill Lutheran Church and its employees and volunteers from any liability in connection with those decisions, I grant permission for emergency treatment by a rescue squad, private physician, and/or hospital or emergency health care facility staff if needed. Any such action will be taken in the best interest of my child and will be reported to be as soon as possible. I HAVE READ AND UNDERSTAND THIS ON-SITE CONSENT AND WAIVER FORM AND SIGN VOLUNTARILY AND ENTIRELY OF MY OWN FREE WILL. (Insert name/date to sign) *
Your answer
I grant permission for Mission Liberty Hill to take and post pictures of my child on the Mission Liberty Hill Facebook page and website from the event. *
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