GraceLife Students Information Form

General Information

Student's Full Name (First and Last)

Student's Cell Phone # (Notifications)

Birthday (MM/DD/YY)

Parent/Guardian Names

Parent's Cell Phone # (Notifications)

Address (Mailing Address including City, State, and Zip)

Email Address

This address will receive a confirmation email

Child's Current Grade

Any allergies or medical needs we need to be aware of?

Additional Information

Will your child be attending Sunday Life Groups?

Yes (In-Person) Yes (Virtually) No

Will your child be participating in AXIS on Sunday nights? (Meets 6:30-8:00)

Yes (In-Person) Yes (Virtually) No

Names of adults that can pick up child other than parents/guardians.

Any special instructions/information that we need to know that will help us teach and work with your child better?

Do you want to designate someone to pick-up your child in an emergency? List name and phone #.

Release For Communicable Diseases Including Covid-19

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I agree

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT

I acknowledge, appreciate, and agree that:

1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS GraceLife Baptist Church, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

Description

We are excited that your child will be participating in one of our student ministries! This is going to be an EPIC year!

GraceLife Students Information Form

Description

Please Fix the Following