By filling out this form you are consenting to put your greatest treasure into our care, which is our honor and pleasure. We will do everything we can to keep your child safe and sound as we participate in the event. For each activity we keep in mind safety considerations and emergency procedures so that if anything unfortunate happens we will be ready. However, there are times when unforeseen circumstances beyond our control do occur, and the statements below are intended to protect the congregation and staff of Cross Keys Baptist Church in those situations.

In consideration of your accepting my child for participation in event, I hereby, for my heirs, executors, administrators, and myself waive and release any and all rights and claims for damages that I may have against Cross Keys Baptist Church and its agents, employees, representatives, successors and assigns for any and all injuries suffered by myself or my child that arise out of event sponsored by the above named organization.

I warrant that I have the right to authorize the foregoing and do hereby agree to hold the above named organization harmless of and from any and all liability of whatever nature, which may arise out of or result from such participation.

For the consideration stated above, I further agree that in the event that my child or I should make any claim against the above named organization for damages arising out of the above named program, activity or sport, I will personally indemnify, defend, and hold harmless the organization and its agents, employees, representatives, successors, and assigns against any and all loss and damage, occasioned thereby, including attorney's fees.

By filling out the form below I give permission to treat my child in case of a medical emergency. By signing below, I also give permission to Cross Keys Baptist Church to use photographs, videos, and other recording, likenesses and images in promoting other activities sponsored by the church.

Also, by typing my name as the Billing Contact, I am signifying that I am the child's parent or legal guardian.