Name of child attending DiscipleTown (Required)
Please fill out a separate form for each child attending DiscipleTown this year
My Children Can Ride Home With? (Required)
This will be people in addition to parents listed on this form.
My Child Has Permission to Walk Home on Their Own. (Required)
You must include physical address on this form if your children will be walking home.
Emergency Contact (Required)
In the event of an emergency, who do we contact? Include relationship and phone number if other than the parents listed on this form.
I understand that all reasonable safety precautions will be taken at all times by Harvest Community Church and it's agents.
By submitting this form, I agree not to hold HCC and/or its employees and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form. I authorize any treatment by an accredited hospital and/or physician deemed necessary for the subject of the release in case of emergency. I understand the possibility of unforeseen hazards and know the inherent possibility of risk.
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