Life Kids Conference Registration

Life Kids Conference Registration

July 15-16, 2022
Parent/Guardian Information
Full Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Campus*

Humboldt ParkSpanish CampusNorthwestSouthwestElginHartfordCamdenTampa BayOther
Child's Information
Child's Full Name*

First NameLast Name
Child's Age*
Child's Grade Level*

1st2nd3rd4th5th
Child's Gender*

BoyGirl
T-Shirt Size | Youth Sizes*

X-SmallSmallMediumLargeX-Large
Waiver/Consent Form
I, Parent's Full Name*, give permission to my child, Child's Full Name*, to attend the Life Kids Conference activities at New Life Covenant.

Liability Release and Consent for Treatment in the unlikely event my child is injured while participating in activities at Life Kid Conference (LKC) or route to such activities, my child and I relinquish all rights to recover damages for any and all injuries sustained by my child. In consideration for Life Kidz Conference, I am granting my child permission to participate in New Life Kids Conference activities, I hereby release Life Kids Conference, New Life Covenant, its employees and volunteers from liability or injuries occurring in (LKC) activities.

In case of emergency, I hereby authorize Life Kids Conference to contact emergency personnel and release pertinent personal information so that my child may receive treatment.
Liability Release, Consent for release of information and for any treatment.*

YesNo
Will your child be carrying an epi-pen?*

YesNo
List any allergies, medical, or other special conditions we should be aware of. If none, write N/A.*
Name*

First NameLast Name
Signature*

Clear
I HAVE READ AND UNDERSTAND THIS PERMISSION FORM AND UNDERSTAND THAT NEW LIFE COVENANT IS RELEASED FROM LIABILITY AS A RESULT OF ANY INJURY OR DAMAGES FROM MY CHILD’S PARTICIPATION IN LIFE KIDS CONFERENCE. I ALSO UNDERSTAND THAT IN THE EVENT OF EMERGENCY OR MEDICAL NEED, I HAVE GIVEN MY PERMISSION TO HAVE MY CHILD RECEIVE MEDICAL TREATMENT BY THE BEST MEANS AVAILABLE.
PAYMENT

$25

Payment*

Life Kids Registration

$25.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Should be Empty:

Life Kids Conference Registration

Parent/Guardian Information

Child's Information

Waiver/Consent Form

PAYMENT

Payment Methods