Please fill out at least one of the following three: Mother's name and phone, Father's name and phone, or legal guardian's name and phone.
I understand that I have a duty to provide primary accident and medical insurance for my child/ and I declare that my child is covered by primary accident and medical insurance.
I Release and forever discharge The Lutheran Church of St. Paul and their agents and servants, successors and assigns, directors, trustees, officers, employees and other representatives from any and all damages of my child's participation in, attendance at, and travel to and from activities and events. Furthermore, I do hereby expressly stipulate, and agree to indemnify and hold forever harmless The Lutheran Church of St. Paul and its agents and servants, successors and assigns, directors, trustees, officers, employees, and other representatives against loss from any and all present or future claims, demands, or actions in law or in equity that may hereafter be made or brought my me or my child, by anyone on behalf of me or my child, or by anyone else on their own behalf for damages or any other legal or equitable remedy on account of any injury, illness, physical condition, inconvenience, or loss sustained by me or my child during the event or travel to and from the same.
By checking "I Agree" below, I hereby acknowledge that I have read the foregoing, understand its contents, and have consented the same as my own free act and deed.