KIDS GAMES REGISTRTION FORM
Date(s) of KidsGames AUGUST 5th and 6th
Friday Aug. 5th 5:30PM - 8PM
Saturday Aug. 6th 9AM - 3PM

AWARDS:
Sunday Aug 7th 11AM - 12:30
Wings Christian Fellowship and CCS

wingskids2011@gmail.com

Parent's Name
Phone #

Emergency Contact Name
Emergency Contact Phone #

Student's Name
Special Medical needs

Doctor
Doctor's #

Authorized to Treat Minor: In the event that I cannot be reached in an emergency, I hereby permit to call 911 and/or to contact a medical facility or physician selected by the School to provide proper treatment to [student's name] and that I will be responsible for all expenses arising in association with such treatment.

Prescription or Over the Counter Medication: I certify that I have on my file in the School office, a current profile enlisting necessary medications that student must take.

Acknowledgment of Notification Regarding Risk: I hereby acknowledge that I have been notified whether or not the activities involved in this field trip are considered to be of "high risk" to the participants.

Indemnity and Waiver of Claim: I, the undersigned, the Parent / Lawful Guardian of the student, hereby acknowledge that as a condition of the Student participating in the activity, agree to indemnify and hold harmless the School, its employees and volunteers, the School District involved, its governing board, the individual members thereof, and all other district officers, agents and employees from any liability, lawsuit, cost, expense or claim of any type whatsoever (including legal fees) for any harm, injury or death arising out of the above mentioned activity.

Parent's signature
Today's date

OR Email the following info to wingskids2011@gmail.com

Parent's Name
Phone #
Emergency Contact Name
Emergency Contact Phone #
Student's Name
Special Medical needs
Doctor
Doctor's #