Amazing Race

Parent Permission Slip

If you have two children that plan on attending the Amazing Race, please fill out this form for each child individually. Thank you. 

type your name

type your child's name

and agree that I/We have had plenty of time to read and understand the following before signing it. I also acknowledge that I am aware of and give permission for my child to be in a vehicle driven by a Keystone Youth Worker for the purposes of this event. 

I, individually and on behalf of any other parent or guardian of the Child agree to release, indemnify, defend, and forever discharge Keystone Church and their employees, representatives, members, directors, staff, and volunteers of and from any and all claims, losses, injuries (up to and including death), demands, rights, and causes of action which may result from participation of the child in the Amazing Race. This Release is in addition to any other Release which I/We may have previously signed in favor of Keystone Church.

I/We know that children can be injured, sometimes seriously, up to and including death, at off-campus activities.  In the event of an emergency, every effort will be made to immediately contact the parent or guardian at the phone number(s) listed below.  If I/we cannot be reached at the phone number(s), I/We give permission to the physician selected by Keystone Church to hospitalize, secure proper treatment for and order injection(s), anesthesia, or surgery for the child as the physician(s) sees fit.  I/We release Keystone Church and their employees, members, directors, volunteers, and any physician and hospital for any medical treatment provided hereunder.  I/We agree to be completely responsible for any and all treatment and related costs for medical and dental services provided pursuant hereto. 

By typing your name above, you are electronically signing your name to the form.

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