Liability Release for
Ministry
Who are you filling out this form as?
*
Participant (Minor)
Parent/Guardian
This form is to be filled out by the Parent/Guardian. If that is not you then send this link by text or email to that person. Thank You.
Participant Name
*
Enter participant name as would be signed.
Participant E-mail
*
Guardian email can be used here. Please review email for accuracy.
Parent/Guardian 1 Name
*
This person ALONE is responsible for supplying information for the participant.
Parent/Guardian 1 Email
*
Please review email for accuracy before continuing.
Add Additional Second Guardian (optional)
Parent/Guardian 2 Name
Guardian 2 Email
Emergency Contact Full Name
Emergency Contact Phone Number
Event Type
Work
GAIN No Medical
Start Date
End Date
Admin Name
Admin Email
Admin Email2
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Should be Empty: