LWC Youth Lock-In
January 4th 5:30 pm- 10 am. $8 Fee. Things to bring will be appropriate PJ's, pillow and sleeping bag or blankets.
Email address *
Name(s) of youth attending and age. *
Your answer
TWO emergency contact numbers. *
Your answer
Person who will pick up on Saturday morning. *
Your answer
Does your youth have any food allergies? *
If yes, please list below.
Your answer
Does your youth have any medical problems? *
If yes, please explain.
Your answer
Does your youth take any medications? *
If yes, please give details of dosage and time.
Your answer
I do understand that this is a cell phone free zone for youth but a leader can be reached at 706.299.3427 through the whole night. *
Consent & Waiver Form I agree to allow my child to participate in the Living Word Church Youth Lock In event held on January 4, 2019. I recognize certain risks and dangers exist in any event setting, and I voluntarily assume these risks. I agree that my child is expected to abide by the rules of the Youth Lock In, and understand that the Living Word Church staff, pastors, volunteers and other event participants shall assume no responsibility or liability for my child for an accident, illness, personal injury, property damage, or other loss caused either by negligence or risks inherent in the Event. On behalf of myself and my child I hold the Living Word Church staff, pastors, volunteers harmless from any and all liability, action, claims, and damage of every kind arising from the Living Word Church Youth Lock In. I authorize and request such medical and surgical services as may be necessary for the care of my child, and further agree to accept financial responsibility for same. The submission of this document is an acknowledgement that I agree to the terms of the agreement on behalf of my child. *
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.