2018 Gospel Fun Day Registration Form
Your Name *
Your answer
Your Email *
Your answer
Your cellphone number in case of we need to reach you during GFD *
Your answer
Spouse or Significant Other's Name
Your answer
Your Spouse or Significant Other's Email
Your answer
Emergency Contact and Phone Number (ie. family member who will not be on site) *
Your answer
Child #1's Name
Your answer
Child #1's Age/Grade
Child #2's Name
Your answer
Child #2's Age/Grade
Child #3's Name
Your answer
Child #3's Age/Grade
Comments/Requests (please indicate any food allergies or medical concerns for each child)
Your answer
THIS FORM MUST BE ON FILE BEFORE YOUR CHILD(REN) CAN PARTICIPATE IN GOSPEL FUN DAY ACTIVITIES
Exodus3 Church Consent

In signing this waiver, I am acknowledging that I am the parent or legal guardian of the child/children named above, OR I have obtained permission from the parent/legal guardian of the child/children, to execute this agreement on their behalf. In addition, I certify that the child is physically and mentally fit to participate in Covenant Ministry's (CM) Gospel Fun Day.

Release of Liability
In consideration of Exodus 3 Church allowing the participant to participate in Covenant Ministry events and activities, I, the undersigned, do hereby release, forever discharge and agree to hold harmless Exodus 3 and it’s pastors, leaders, volunteers, agents or representatives (collectively herein “Exodus 3 Church”) from any and all liability, claims, or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred. I understand and agree that Exodus 3 Church will not be held liable in any way for any injury, harm, damage, or death that may occur AND hereby release Exodus 3 Church from any injury, harm, damage or death, which may occur. This release of liability is also intended to cover all claims that members of the child’s family or estate, heirs, representatives or assigns may have against Exodus 3 Church. I further agree to indemnify and hold harmless Exodus 3 Church from any and all claims arising from my child’s/children’s participation in Covenant Ministry activities and programs, or as a result of injury or illness during such activities.

I warrant the truthfulness of the information provided in this form. I understand that typing my first and last name in this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance and Agreement.
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