VBS 2017 Online Consent & Release Form

  • Guardian Consent

  • I, do hereby certify that I am the parent/guardian of the child listed below and that I give consent for him/her to participate in COLFC – Vacation Bible School (07/08/19 - 07/12/19) under the sponsorship of Church of Love Faith Center, 700 Exchange Street, Rochester, NY 14608. The youth will be attending VBS events from 9 am to 12 pm.
  • In case of an emergency, I may be reached at the phone number listed.
  • I have also listed emergency contacts who may make medical decisions for my child in my absence. In the event I can’t be reached or my child's listed emergency contact, I do hereby authorize the Church of Love Faith Center sponsoring program to make emergency medical decisions for my child. .
  • If there is an activity I do not wish my child to be involved in, I have listed them.
  • Release and Acknowledgement

    I UNDERSTAND AND DO HEREBY AGREE, TO ASSUME ALL OF THE RISKS INVOLVED WITH THE SAID EVENT, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO.  I do hereby agree to hold Church of Love Faith Center and its agent s and its employees harmless from any and all liabilities, actions and causes of actions, claims, damages a nd expenses incurred from injury to my child or property, even injury resulting in death either now or in the future as associated with said activity and participation.  I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of New York and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and the terms of this release are contractual and not mere recital. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND SIGN THIS RELEASE AS MY OWN FREE ACT.  This is a legally binding agreement, which I have read and understand.