Awana Registration

Liability Information (You will need to initial below that you have read and agree to the following): I, the undersigned parent/guardian hereby consent to my child(ren), participating in activities connected with BETHANY COMMUNITY CHURCH in Washington, IL. I certify that my child is able to participate in these activities including sports, hiking, ropes course, Zipline, & swimming, etc. (unless otherwise indicated). I have listed any activities I do not want my child to be involved in. I UNDERSTAND & HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY & SUBSEQUENT THERETO. If my child has medical conditions, which may be relevant to a physician in the event of an emergency, I have listed them. In the event that an emergency occurs, I may be reached at the telephone number(s) listed. If I cannot be reached within a reasonable period of time, I hereby authorize the Bethany Community Church staff to make emergency medical decisions for my child. I consent to the use of my child’s portrait or picture for purposes of trade, publicity, & or information by Bethany Community Church. I do hereby agree to hold Bethany Community Church & its agents & employees, harmless from any & all liability, actions, causes of action, claims, expenses, & damages on account if 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 to participation in any other associated activities. I expressly agree that this release, waiver, & indemnity agreement is intended to be broad & inclusive as permitted by the State of Illinois law & that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force & effect. This release contains the entire agreement between the parties hereto, & the terms of this release & contractual & to a mere recital. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE & KNOW THE CONTENTS THEREOF & I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement, which I have read & understand. Initial here.

Awana Registration

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