MIDDLE SCHOOL WATER DAY - June 20

We will be leaving campus for an End of Middle School Celebration Water Day. We will be playing water games and swimming at 5323 11th St SE., Lakeland, FL 33813. The students will be transported to the event then back to the church for pickup at 8:30pm.

Youth's Name

Last Name

THINGS TO BRING:

Towel
Change of clothes
Make sure to wear modest bathing suits (1 piece or modest tankini)

Youth's Phone Number

Grade

Are there any allergies. medical, or other special conditions we should be aware of: (optional)

Parent's Name

Last Name

Parent's Phone Number

Emergency Contact

Last Name

Emergency Contact's Phone Number

I give permission:
(1) For my child to take part in this program/event sponsored by Scott Lake Baptist Church.
(2) To use event photos/video which include my child for church promotions and publicity.
(3) To administer first aid or seek immediate emergency medical care should it be required for my child (undersigned is responsible for all expenses incurred for emergency care services).
(4) For my child to ride in church vehicles or vehicles driven by approved volunteers while attending this event.

Liability Release:
I agree to release and hold harmless the church, church employees, and church volunteers from any and all liability to or responsibility for bodily injury, damage, or illness to my child while participating directly or indirectly in this program/event.

Signature