Awana Visitor Form • Maranatha Baptist Church

Child's Full Name *

In what grade is Child #1? *

Child #1: Allergies?

Do you have another child visiting Awana? *

Yes

Child #2 Full Name *

In what grade is Child #2? *

child #2: Allergies?

Parent/Guardian's Full Name *

Phone Number *

Email Address *

Parent/Guardian #2's Full Name

Phone Number

Email Address

Name of the person/people who have your permission to drop off and pick up your child. *

If your child was invited by a friend in Awana, who is that friend?

Consents

Release of Liability & Assumption of the Risk

In consideration of being allowed to participate in Maranatha Baptist Church programs, events and activities, the undersigned acknowledges, understands, and agrees that:

There is the possibility and risk of injury, even serious injury, associated with my child(ren)’s participation; and,
There is the possibility and risk of exposure to and illness from infectious diseases associated with my child(ren)’s participation, including but not limited to MRSA, influenza, and COVID-19. While particular protocols and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child(ren)’s participation; and,
I agree to carry insurance, or have the financial resources, to cover the expenses related to personal illness, personal injury, injury caused to others, and/or damage to property.
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Maranatha Baptist Church, its officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, volunteers, host families, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Enter the name of each participating child. *

Parent/Guardian Digital Signature *

Tip: Please enter your full name.

Date Signed *