Pillar & Oak Nature Group
Release Waiver
Parent or Guardian's Name(s):
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you currently a member of a local church? If yes, where?
How did you hear about Pillar & Oak Nature Group? Please list any current members you know.
I have read the Pillar & Oak Statement of Faith, and can confirm that our family upholds these beliefs as well.
Please Select
yes
no
I am aware of the potential dangers of attending Pillar & Oak Nature Group. I promise not to hold the organization, or it's directors liable or pursue legal action against them. This waiver absolves the organization of any duty for injuries sustained while on the premises of various nature outings before, during, or after the activity. By signing this agreement, I agree to hold Pillar & Oak completely harmless, including financial responsibility for any injuries sustained, regardless of the cause or circumstances. Our family will do all in my power to obey all rules, and all safety requirements posted at the various locations visited, as well as any safety precautions offered by Pillar & Oak directors and leaders. I will seek clarification if necessary.
Please Select
yes
no
Number of Children
Please Select
1
2
3
4
5
6
7
8
Child 1
Child 1
First Name
Last Name
Age by August 1st 2025
Birthday
Current School
Projected grade for 2025/2026
Any special information you would like us to know?
Child 2
Child 2
First Name
Last Name
Age by August 1st 2025
Birthday
Current School
Projected grade for 2025/2026
Any special information you would like us to know?
Child 3
Name
First Name
Last Name
Age by August 1st 2025
Birthday
Current School
Projected grade for 2025/2026
Any special information you would like us to know?
Child 4
Child 4
First Name
Last Name
Age by August 1st 2025
Birthday
Current School
Projected grade for 2025/2026
Any special information you would like us to know?
Child 5
Child 5
First Name
Last Name
Age by August 1st 2025
Birthday
Current School
Projected grade for 2025/2026
Any special information you would like us to know?
Child 6
Name
First Name
Last Name
Age by August 1st 2025
Birthday
Current School
Projected grade for 2025/2026
Any special information you would like us to know?
Child 7
Name
First Name
Last Name
Age by August 1st 2025
Birthday
Current School
Projected grade for 2025/2026
Any special information you would like us to know.
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