I certify that I am the parent or legal guardian of the minor(s) (hereafter mentioned as the “participant”) listed on this online registration. 

By filling out and submitting this form, I consent for the above mentioned people to participate in the associated activities of Lighthouse Baptist Church, namely, Vacation Bible School which occurs from June 2-8, 2025.

I recognize that there are risks involved in participating in any activities and hereby assume all risk of injury, harm, damage, sickness, exposure to infectious/communicable disease, bullying,  discrimination, or death of the participant in connection with any church-related activity. 

To the fullest extent permitted by law, I release Lighthouse Baptist Church, its trustees, officers, directors, employees, agents, and formal or informal representatives from any injury, harm, damage or death which may occur to the participant and agree to save and hold harmless Lighthouse Baptist Church, its trustees, officers, directors, employees, agents, and formal or informal representatives from any claims arising out of the participant’s involvement. 

Further, I, the undersigned, consent to any formal or informal counsel, licensed or unlicensed medical, surgical, x-ray, anesthetic, or dental treatment that may be deemed necessary for the participant.  I understand that efforts will be made to contact me prior to treatment, but in the event I cannot be reached in an emergency, I give permission to the activity leader to make the decisions necessary for treatment.  I give permission to formal or informal church representatives to treat the participant with necessary care.  I, the undersigned, understand that I am financially responsible for the health care decisions of the participant and agree that my insurance plan is the primary plan to pay for the medical, dental, or hospital care or treatment deemed necessary in my absence.  Any insurance policy of the church or organization sponsoring this event will be used only as secondary coverage.

This waiver and release of liability shall remain in effect for the duration of the specified dates, during the initial and all subsequent events of participation.  By submitting this form, I  acknowledge that I understand and agree to all the terms outlined in this document.  

If a legal guardian is submitting this form for a minor, that guardian acknowledges that he/she has legal permission within any current custody agreement of the minor to consent to such a document.