Platform Admin Skip to content

3rd - 6th grade Church Liability Form

Your name *

Last name

Email address *

Type your child's full name here. *

Relation to Child *

Birthday *

Gender *

Grade *

Address *

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Phone Number *

Phone type

In case of emergency, contact: (Name and Phone Number) *

Fellowship Church Assumption of Risk & Release of Liability Form

I agree to the following terms in consideration for participation in the elements of "5's, K-2, 3-6" of Fellowship Church: *

All play areas and structures within our Children's Facilities. (Bird's Nest, Kid's Castle, Zipline, Trike Races, Inflatables, Sports Court, etc.)

I recognize that these activities have risks and could result in serious injury or death.

I assume all risks associated with these activities.

In the event of injury or illness I authorize and consent to: *

Medical treatment for myself and for any minor child for whom I am responsible.

I either have health insurance to cover the cost for such treatment, or I will pay all costs of such treatment.

I agree to release, indemnify and hold harmless: *

Fellowship Church and it's directors, officers, employees, agents, and volunteers (collectively, Fellowship Church.)

From and against all claims, losses, liabilities, demands, and damages (including attorney's fees and costs.)

Whether caused by conduct of Fellowship Church or others related to my participation in the activity.

I assume full responsibility for damage to or loss of my personal property occurring during my participation in the activity and release Fellowship Church from any claim for such loss or damage. *

By checking this box on behalf of a minor, I represent that I am the minor's legal guardian, that I have the legal capacity to sign this form on behalf of the minor, and agree to all its terms on behalf of the minor. *

Type Full Name below to agree and consent to the above. *

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Fellowship Church of Grand Junction
info@fellowshipgj.com
9702457729

Church Center requires JavaScript to be enabled.

Here are some instructions to enable JavaScript in your web browser.

Events | Classes | Seminars Sermons: Weekend Service Next Steps Serve 4640 Student Center Wedding Services Share Your Story