Memorial Baptist Church Waiver and Release
Anyone who is on the church campus for a non- church related activity must complete and submit this document.
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Name (Parent if minor) *
Address *
Phone Number *
Email *
Activity Participating in on campus *
Family member names and ages (of minors) who are participating *
I understand that the group using the church campus is responsible to provide safe guards and protection for their members while on the church campus, including the playground and parking lots.
I will not hold Memorial Baptist Church, it's employees, or volunteers responsible for any and all liability including personal injury, financial costs, property loss or damage.
Clear selection
In a medical emergency, I understand the group using the campus will be responsible for the attendees. It is their responsibility to assess, obtain consent, transport, and contact family.
Clear selection
Electronic Signature *
Date *
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