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Event / Babysitting Date*

Friday Nov 15th - Women's Game Night
Parent's Name*

First NameLast Name
Email*
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Phone Number*
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Number of Children:*
Child's Name*
Age*
Child's Name*
Age*
Child's Name*
Age*
Child's Name*
Age*
Informed Consent and Acknowledgement

I hereby give my approval for my child’s care in any and all activities, prepared by Jannah Circle Inc. NFP, henceforth referred to as JC, during the event. I have willingly placed my child in the care of the JC babysitters. In exchange for the acceptance of said child’s candidacy by JC, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve, and hold harmless JC, and all its respective officers, agents, volunteers, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected sessions.

In case of injury to said child, I hereby waive all claims against Jannah Circle Inc. NFP, including all teachers and affiliates, all participants, staff, volunteers, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all group activities, including open play.

I acknowledge that this is not daycare and a parent/guardian will stay on premise while my child is with the babysitters.
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