Summer Send Off Event Waiver

If you would like to participate in this event, be sure to have a parent or guardian complete the waiver below.

Students Name:*
First Last
Students Date of Birth:*
MM slash DD slash YYYY
Students Grade:*
Allergies or Medical Concerns:
Is this first time your student has attended Cascade Hills Church?*
Additional Participants:
If you have additional children you'd like to register at this time, please use the plus icon below and provide their necessary information.
Full Name: Date Of Birth: Grade: First Time Guest?
Parent / Guardian Name:*
First Last
E-Mail Address:*
Contact Number:*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Emergency Contact Info:
Full Name: Phone Number: Relationship to Student:
Media Release
I hereby give Cascade Hills Church, Student Ministry, permission to publish my child’s name/photo/video on social media.

Yes, I have read and agree to the above media release statement.
Medical Disclaimer:*
Before you can register your child/children or ward to attend Cascade Hills Church – Summer Send Off, you must agree to acknowledge the fact that Cascade Hills Church staff and volunteers are NOT equip to provide medical care beyond basic First Aid. If your child requires potential medical care, they must be accompanied by a trained medical professional.
Yes, I have read and agree to the above medical disclaimer.
Waiver of Liability:*
I take full responsibility of the risk of injury while participating in the "Summer Send Off" event, and I am responsible for the right to participate in the Activity, I hereby knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the "Summer Send Off" event, and do hereby release and forever discharge Cascade Hills Church, located at 727 54th St Columbus, GA 31904, United States.
Yes, I acknowledge and agree to the waiver of liability.
Signature of Parent / Guardian*

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Full Name:	Date Of Birth:	Grade:	First Time Guest?

Full Name:	Phone Number:	Relationship to Student:

Service Information

Summer Send Off Event Waiver

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