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Youth Pool Party
Youth Full Name
*
Enter your full name.
Date of Birth:
*
Address:
*
Enter your email
*
Parent/Guardian Name
*
Enter your full name.
Phone Number(s):
Emergency Contact (if parent/guardian cannot be reached)Name and phone Number:
*
Allergies/Medical Conditions:
Permission & Liability Release
I, the undersigned parent/legal guardian of the above-named participant, hereby give permission for my child to attend and participate in the New Life Chapel Youth Swim Party. I understand that reasonable safety precautions will be taken at all times by New Life Chapel Youth leaders and volunteers, and that my child will be expected to follow all rules and directions. I acknowledge and understand the risks involved with swimming and related activities. I agree to release, hold harmless, and indemnify New Life Chapel, its employees, volunteers, and representatives from any and all liability, claims, or demands that may arise in connection with my child’s participation in this event. In the event of an emergency, I authorize New Life Chapel Youth leaders to secure medical treatment for my child as deemed necessary, including hospitalization, anesthesia, surgery, or injections of medication.
Parent/Guardian Signature
*
Enter your full name.
Date
Select the date.
Submit
