Accelerate Consent and Release Form

I, the undersigned parent or guardian, hereby consent to my child [Child's Name] participating in "Accelerate: Growing in the Gospel" on May 4, an event sponsored by StoneRidge Fellowship Church. I certify that my child is able to participate in any activities.

If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them below. In the event an emergency occurs, I may be reached at the telephone number listed below. If I cannot be reached, I hereby authorize [Adult Sponsor] to make emergency medical decisions for my child. If there are any activities I do not want my child to be involved in, I have listed them below.

I understand and hereby agree to assume all of the risks which may be encountered on said activity, including activities preliminary and subsequent thereto. I do agree to hold StoneRidge Fellowship Church and its agents and employees harmless from any and all liability, actions, causes of actions, claims, expenses and damages on account of injury to my child or property, even injury resulting in death, which I now have or may arise in the future in connection with the activity or participation in any other associated activities.

I expressly agree that this release, waiver and indemnity agreement is intended to be broad and inclusive as permitted by the Laws of Nova Scotia, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital.

I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement, which I have read and understand.
  • First Name
    Last Name
  • First Name
    Last Name
  • Parent/Guardian Signature
  • First Name
    Last Name
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  • Phone numbers where I can be reached in case of emergency:
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