CREW LOCK OUT 2017
• Middle School Ministry Lock-Out for 7th and 8th grade students

• Friday, February, 24 - 9 pm (pick up 7 am following morning)

• $20 includes food, games, dance and T-shirt

• Invite a friend (non Church or School student/member) they come for free!

Email address
Student First Name
Your answer
Student Last Name
Your answer
Grade
School Attending
Required
Allergies or special concerns?
Your answer
Permission to Participate and Photo Release
To be completed by parent or guardian (18 years or older). My child has permission to participate in the youth activities, programs, and ministries of St Paul Lutheran Church. In any youth event, especially those which include traveling, there is the risk of serious injury. I understand that my child needs to be fully covered under my insurance company. The church's insurance will only cover medical costs not covered by my insurance. In the event of a medical emergency when I, the parent or legal guardian, cannot be reached, I hereby authorize the youth leader, or designated adult counselor, to secure the necessary medical or dental treatment at any hospital, clinic, or doctor's office. I also agree that in no way will the church, youth leader, or adult counselor, be held liable for actions taken in good conscience in an emergency situation.
Required
Parent Name(s)
Your answer
Best phone number to be reached on night of Lock-In
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone
Your answer
A copy of your responses will be emailed to the address you provided.
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