CaveQuest! Registration
Vacation Bible School @ Hope Lutheran Church: August 8-12, 2016
Last Name
Your answer
First Name (Child 1)
Your answer
Last Grade Completed
First Name (Child 2)
Your answer
Last Grade Completed (Child 2)
First Name (Child 3)
Your answer
Last Grade Completed (Child 3)
First Name (Child 4)
Your answer
Last Grade Completed (Child 4)
Email Address
Your answer
Phone Number 1
Your answer
Phone Number 2
Your answer
Phone Number 3
Your answer
Home Address
Your answer
Home Church
What special concerns or dietary restrictions do we need to know about your child?
Your answer
Please name all adults authorized to pick up your child:
Your answer
Does Hope Lutheran Church have permission to publish pictures of your child (picture only- no name) online?
Required
I/We the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend events being organized by the Church. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release the Church, its pastors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our child’s involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. I/we also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member.
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms