PARENTAL CONSENT

(If applicant is under 18 both sections must be filled out.)

I/we hereby agree that ______________________________ has our permission to participate in the _____________________________.  By signing this I/we have received, read, and agree that he/she is expected to obey and respect those in authority regarding policies and rules pertaining to this trip.

  Parent’s/ guardian’s signature if applicant is under 18 years of age:

Date:____________________________________

Applicant’s signature: ___________________________

LIABILITY RELEASE

(All applicants must fill this section out)

I/we hereby release the Church at the Heights, South Canonsburg Church, or the Evangelization Society, its ministers, employees, and volunteer assistants from any and all liability whatsoever arising out of any injury, damage, or loss which may be sustained by said person during the course of involvement with the Church at the Heights, and the E.S.  I/we release the Evangelization Society, its ministers, employees, and volunteer assistants from any and all liability whatsoever arising from any violation of laws, statutes, or ordinances by said person during the course of involvement with the Church at the Heights, South Canonsburg, and the ES.

Parent’s/ Guardian’s Signature.______________________________________

DATE:_______________________

APPLICANT’S SIGNATURE ________________________________________