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					                     Laser Quest                                                                Laser Quest
                             Wed. April 4                                                               Wed. April 4
                             Time: 5-10                                                                 Time: 5-10
                             Meet at BBC                                                                Meet at BBC
                              Cost: $20                                                                  Cost: $20

              BRADFORD BAPTIST CHURCH                                                    BRADFORD BAPTIST CHURCH
          PERMISSION & LIABILITY RELEASE FORM                                        PERMISSION & LIABILITY RELEASE FORM

I give permission for my son/daughter ______________ to go with            I give permission for my son/daughter ______________ to go with
Bradford Baptist Church and for the designated sponsors to act as legal    Bradford Baptist Church and for the designated sponsors to act as legal
guardians for the duration of the activity. I also release Bradford        guardians for the duration of the activity. I also release Bradford
Baptist Church and its designated sponsors from all liability in case of   Baptist Church and its designated sponsors from all liability in case of
accident or injury.                                                        accident or injury.
HEALTH CARD # _______________________                                      HEALTH CARD # _______________________
DATE OF ACTIVITY _____________________                                     DATE OF ACTIVITY _____________________
SIGNATURE OF PARENT OR GUARDIAN _______________                            SIGNATURE OF PARENT OR GUARDIAN _______________
PHONE # _______________________                                            PHONE # _______________________
DATED _________________________                                            DATED _________________________
Are there any medical notes we need to be aware of?                        Are there any medical notes we need to be aware of?
____________________________________________________                       ____________________________________________________
Student: I hereby acknowledge that I will obey all rules and               Student: I hereby acknowledge that I will obey all rules and
regulations set by the sponsors. I will acknowledge that I understand      regulations set by the sponsors. I will acknowledge that I understand
the rules and will give the utmost of good behaviour.                      the rules and will give the utmost of good behaviour.

               Signed ______________________________                                      Signed ______________________________

Leaders: Melissa Genik, Jesse Walker, Patti Larose, Kelsey                      Leaders: Melissa Genik, Jesse Walker, Patti Larose, Kelsey
             Stebbings, and Randy Smith..                                                     Stebbings, and Randy Smith

				
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posted:9/28/2012
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