Thrive Youth Rally May 12th
I, the undersigned parent or guardian, hereby consent to my child participating in Youth Rally, an event sponsored by First Baptist Community Church of Los Gatos on May 12, 2018. I certify that my child is able to participate in these activities including but not limited to, transportation to and from, playing games, and eating. If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them below. In the event an emergency occurs, I may be reached at the telephone number listed below. If I cannot be reached, I hereby authorize Pastor Daniel Sternquist or his agents to make emergency medical decisions for my child. If there are any activities I do not want my child to be involved in, I have listed them below. I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITY, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I do hereby agree to hold First Baptist Community Church of Los Gatos and its agents and employees, harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities. I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of California, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto, and the terms of this release are contractual and not a mere recital. I further stat that I HAVE CAREFULLY READ THE FORGOING RELEASE AND KNOW THE CONTENTS THEREOF, AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement which I have read and understand. Parent/guardian name:
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Full Name of participant
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First Name
Last Name
E-mail
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Todays Date
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Please list any food allergies your child might have
Phone Number where you could be contacted in case of emergency
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Electronic Signature: By entering my name below, I accept the above conditions and releases. (You must be 18 years old or over to sign below.)
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First Name
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