Wavier | Churches United

CHILD ACTIVITY & FOOD CONSUMPTION

COMPREHENSIVE LIABILITY WAIVER

RELEASE, ASSUMPTION OF RISK, AND INDEMNIFICATION AGREEMENT

IMPORTANT LEGAL NOTICE – READ CAREFULLY

This document is a legally binding contract. By signing, you are waiving and releasing certain legal rights, including the right to sue Churches United, Inc. and related parties.

Event Information

Event Name

Event Date

Location

This form is for:

My Child(ren)

Both

I, the undersigned adult participant, parent, legal guardian, or authorized responsible adult, sign this waiver on behalf of myself and/or the minor child(ren) or individual(s) listed below. For purposes of this agreement, “Participant(s)” means myself, my child(ren), and any minor or individual under my care, custody, or supervision during this event.

Parent/Legal Guardian Information

First Name

Last Name

Parent/Guardian Birthdate

Phone Number

E-mailAddress

Minor Information

#1 - Child's Name

#1 - Date of Birth

#2 - Child's Name

#2 - Date of Birth

#3 - Child's Name

#3 - Date of Birth

#4 - Child's Name

#4 - Date of Birth

#5 - Child's Name

#5 - Date of Birth

If you have more than 5 children, please fill out an additinal form.