Fuller Lake Skating

Activity: Skating at Fuller Lake Arena for Public Skate and/or Teen Skate

Activity Details:

Meet at Fuller Lake Arena for 6:30 PM (if you need a ride please email Kaylee at kaylee@bethelonline.ca)

COST: Please bring money to purchase a ticket for skating and rentals (if needed)!

Dear Parent:

We are planning an activity as part of our programming that requires your permission prior to participation. We have provided you the details of the activity and request that you complete and sign the permission form. Please note that all physical activities have risks. The safety of your child is our primary concern. Precautions will be taken for their well-being and protection.

The risks associated with the activity include but are not limited to: head injuries, broken bones, bruises, and other injuries, and death.

Please select what your student will be attending and bring the correct amount of money to pay.

My student will be attending:*

Only public Skate (6:30PM - 8:00PM) Cost: $5Only Teen Skate (8:20PM - 9:20PM) Cost: $2Both public skate and teen skate Cost: $7Rentals (unsure of cost)

Student Name*

First NameLast Name

Please Select Grade*

Any allergies, medical conditions, or behaviours we should know about? *

Guardian's Name*

First NameLast Name

Guardian's Phone Number*

Please enter a valid phone number.

Guardian's Email*

example@example.com

Emergency Contact's Name (Different from Guardian)*

First NameLast Name

Emergency Contact's Phone Number*

Please enter a valid phone number.

Would you like to be signed up for our monthly Bethel Youth email?*

YesNoAlready signed up

I voluntarily agree and consent to the participation of my/our Child(ren) in this supervised activity.

While every precaution is taken for the safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at Bethel Church. I/we understand that I am exposing my Child to inherent risks and hazards. I accept all these risks and hazards and agree that by allowing my Child to participate in those activities and acknowledge that I will be responsible for any injury or other loss which may occur during my Child’s participation of these activities.

I/we, the Parents or guardians named below, authorize the Pastor or one of Bethel Church’s Personnel to sign consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

I/we, named below, undertake and agree to indemnify and hold blameless Bethel Church, its Personnel, its leaders and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Bethel Church, as well as of any medical treatment authorized by the supervising individuals representing Bethel Church. This consent and authorization is effective only when participating in or traveling to events of Bethel Church.

I have read, understood and agree with above.

Activity: Skating at Fuller Lake

I, First Name* Last Name* herby acknowledge and agree that by typing my name below I intend to sign this document electronically. I understand that my typed name will have the same legal effect as a handwritten signature.

Parent/Guardian Name (Electronic Signature)*

First NameLast Name

Today's Date*

Date

Skating at Fuller Lake Arena

Permission Form and Consent