Child/Youth Registration "*" indicates required fields Parent/Guardian/Host InformationParent/Guardian 1* First Last Email* Phone*Relationship to Child* Parent/Guardian 2 First Last Email PhoneRelationship to Child Child InformationFirst Child's Name* First Last Male or Female* School* Grade* Date of Birth* MM slash DD slash YYYY Allergies or Special Needs?Next Child's Name First Last If ApplicableMale or Female School Grade Date of Birth MM slash DD slash YYYY Allergies or Special Needs?Next Child's Name First Last If ApplicableMale or Female School Grade Date of Birth MM slash DD slash YYYY Allergies or Special Needs?Next Child's Name First Last If ApplicableMale or Female School Grade Date of Birth MM slash DD slash YYYY Allergies or Special Needs?Consent* By checking this box I consent for all listed children.I/we give permission for (name of all children/youth listed) to participate in the activities of Lifeway Church, both on the church premises and elsewhere. In consideration of the opportunity of my/our child/youth to participate in the activities of Lifeway Church, I/we release Lifeway Church, its officers, agents, employees, staff, and volunteers from any and all liability of any kind whatsoever for any loss or injury to my/our child/youth arising from my/our child/youth's participation in the activities of Lifeway Church; and I/we agree to indemnify and hold forever harmless the Lifeway Church, its officers, agents, employees, staff, and volunteers from any and all liability of any kind whatsoever for loss or injury to my/our child/youth arising from activities on or off the premises of Lifeway Church or resulting from traveling to or from the activities of Lifeway Church, including loss or injury resulting from negligence or gross negligence. Δ
