Life Kids Conference

Consent Form
I give my full permission to _______________________ to attend and participate at Life Kids Conference held by New Life Covenant Church HP Campus at 3400 West Division Street, Chicago, IL 60651.

In the unlikely event that my child is injured while participating in activities at Life Kids Conference or en 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 of Life Kids, I am granting my child permission to participate in Life Kids Conference activities and hereby release Life Kids Conference, its employees and volunteers, and New Life Covenant Church Ministries from liability or injuries occurring.

In case of emergency, I hereby authorize Life Kids Life Kids Conference employees and/or volunteers to contact emergency personnel and release pertinent personal information so that my child may receive treatment.
I acknowledge that I have read and understand the above information.*

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

YesNo
I give permission for my child to be transported in a vehicle...*

YesNo
I give permission for photos to be taken of my child participating in activities...*

YesNo
Allergies, Medical Needs, Dietary Restrictions*
Emergency Contact
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to Participant*

Registration Payment*

Life Kids ConferencePayment includes conference admission, lunch and dinner 7/7, and a t-shirt.

$25.00 Quantity

Total

$0.00

Emergency Contact