Play Night

Participant's Name

Participant's Date of Birth

Parent/Guardian's Name :

Parent/Guardian Phone:

Parent/Guardian Email:

This address will receive a confirmation email

Secondary Emergency Contact and Phone Number

Health Insurance Carrier and Policy Number

Any allergies/Disabilities? (This will also help us plan food and snacks)

Please Read and Sign

I understand all reasonable safety precautions will be taken at all times by Faith Community Church and its agents during the event and activities. I authorize any treatment by an accredited hospital and/or physician deemed necessary for the subject of the release in case of an emergency. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Faith Community Church, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form. I give permission for my son/daughter to attend.

Description

Saturday February 18, 4-7pm

Join us for Play Night for our toddlers and preschoolers! Parents are invited to sign up their children and drop them off, and go out and enjoy a night for themselves. We will provide all the fun and snacks and dinner.

Play Night

Description

Please Fix the Following