Check-Out Liability Form
This form MUST be completed before entry. A form must be completed for EACH STUDENT attending. [As a student, you can fill this form out to the best of your ability if you drove your own car or you rode with another student and the parent is NOT present.]
Student's Full Name
*
First Name
Last Name
Please tell us how the above named student is being picked up. If you are the student, please select the option that best describes how you will be picked up.
*
I am a parent/guardian picking up the above named student.
The above named student is not my child, but is in my carpool.
I am a student and have consent to drive myself.
I am a student and I have consent to drive myself and others.
I am a student who rode in a carpool.
Type the name of the driver who is taking the student named above home. If you are the student driving yourself or a carpool, please type your name.
*
All phones will be turned in at registration (or are to be kept with the parent/guardian) along with any other tech/electronics. Should you (the parent or guardian) need to reach your child, please contact one of your student's leaders. For quick contact (if you do not have contact information), call or text the Retreat Administrator Macey Fernandez at 615-686-1993.
If you are a student at Winter Retreat and you drove, you must turn in your keys at registration and they will be kept safe with your phone/other tech items. This will ensure that no one leaves during the hours of Winter Retreat. Should your student need to leave early, please email us those details at
youth@newsongnashville.com
so we can accommodate each situation as it comes.
By signing below, you are consenting to adhere to the aforementioned details of participating at Winter Retreat.
Please sign below to confirm that you have answered the above prompts truthfully and to the best of your ability, releasing New Song Nashville, New Song Christian Academy, Seeds, Springhouse and Southview of any liability per Release & Consent statements in the registration form as well as the details listed above regarding phones/tech + keys.
*
SUBMIT
Should be Empty: