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Laser Quest Permission Slip

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					Laser Quest Permission Slip
Date: Friday, Feb 16, 2007 Location: Laser Quest, 13711 Westheimer Rd., Ste H. Houston, 77077. 281-596-9999 Time: 7:30-9:45pm Cost: $13 RSVP: Thurs, 2/15 – email jodiyin@yahoo.com so we know how many to expect. This is an Ignite social event for any youth at WHCC. Note: Students will leave from church at 7:30. Parents must pick up their child at Laser Quest at 9:45pm. No rides back to church will be provided.

West Houston Chinese Church
Liability Release
I, ________________ (name of parent), parent or guardian of _______________, hereby release WHCC, its pastors and governing councils, and the volunteer staff from any liability whatsoever arising out of any injury, damage, or loss that may be sustained by the aforementioned minor during the course of involvement at Laser Quest. In the event of an accident, I give the WHCC staff members the permission to secure immediately needed medical aid, and relieve WHCC of liability in such an event. I also agree to bear all incurred medical expenses. _________________________
(Students under 18 require parent/guardian signature.)

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Date

Emergency Phone Number: ____________________ Medical Insurance Information: Insurance Company ______________________ Policy Number _________________________


				
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Lingjuan Ma Lingjuan Ma
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