Proehlific Park 5DC

Summer is here! We want to invite you to our 5 Day Club at Proehlific Park held on June 29-July 2. It will be a wonderful time of making friends and being creative as we learn about the Bible. We will begin at 1:00 p m and run through 2:30 p m. Your children will be in the care of trained volunteers who have been background checked and are ready to help them make new friends and life long memories. This club will be hosted by Child Evangelsim Fellowship. Make sure to invite your friends!

Parent/Guardian Name*

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Parent/Guardian Name

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Child's Name*

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Date of Birth*

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Emergency Contact 2*

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Permission to pickup other than above

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Photography and Video Release

Child Evangelism Fellowship ® may, from time to time, document the activities of the CEF ministry with photos or videos.

I hereby assign and grant to Child Evangelism Fellowship Inc., its subsidiaries and successors, and assign the unqualified right to the ownership, use and proceeds of all photographs or videos from these CEF activities of me or my minor child, without reservation or limitation royalty free, including use of photographs or videos of me or my minor child for, advertising, educational and for CEF promotional purposes.*

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I, Parent First Name Parent Last Name, understand that I am giving photo and video consent as listed above for my child,First Name Last Name. I do understand that typing my name is valid as a signature and issue my consent on Date

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Parent/Guardian Printed Name:_______________________________

Child’s Name:_________________________________________________

Proehlific Park 5 Day Club Permission Form