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Summer Day Camp Waivers

Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Phone *
Parent/Guardian Phone
Permission for my child(ren) to participate in the Summer Day Camp 2019 at Weird Church *
I hereby release, remise, and forever discharge the United Church of Canada, its staff or volunteers, of, and from, all manner of actions, causes of actions, claims, and demands of whatever nature which result from any injury, loss or expense sustained, arising out of or in any way connected with participation in the SUmmer Day Camp Program. In the event that my child is injured, ill, or in need of medical attention (and I am unable to be contacted), I authorize the leaders of the retreat to seek medical attention on my behalf.
Permission for the leaders of the Weird Church Summer Day Camp 2019 to use a photo of my child (ren) for a church publication or on a church website. I understand that my child's name will not be published on the internet. *