OFY Registration Form

 Program Info 

• Event Timing: Every Saturday From 6:00Pm - 8:30pm 
• Event Address: 9 south 8th Ave. (Grace Of Christ Church)
• Contact us via Text or Email : (509) 952-5849 or sjp9291@aol.com 

Parents/Guardians Information

Emergency Information

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by On Fire Ministries and Grace of Christ church during the selected duration. In exchange for the acceptance of said child’s candidacy by On Fire Ministries., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless On Fire Ministries and Grace of Christ church and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against On Fire Ministries and Grace of Christ church including all leaders and affiliates, all participants, 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 sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Video Consent and Release 

Without expectation of compensation or other remuneration, now or in the future, I heby give my consent to On Fire Ministries, its affiliates and agents, to use my childs image and likeness and/or any interview statements from them in its publications, advertising or other media activities (including the internet)

The below signed parent or legal guardian of the above-named minor child hereby consents to give permission to the above on behalf of such minor child.

 

 

Medical Release and Authorization

As Parent and/or Guardian of the named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named child. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to On Fire Ministries and Grace of Christ church. and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.