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Youth Rally Registration

To register, please take the time to fill out the information below.

Gender
Male
Female

Participant Agreement

Do you Agree to the Application above?
Yes
No

Parent/Guardian Agreement

As the parent and legal representative of the above named child, I give my consent and permission for my child to participate in the activity listed above.  I understand that participating in the activity is a privilege and not a right and may be revoked at any time by the instructor in her discretion.


I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED WITH MY CHILD’S PARTICIPATION IN THE ABOVE NAMED ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO, INCLUDING TRANSPORTATION TO AND FROM EVENTS.  I do hereby agree to hold EMMANUEL BAPTIST CHURCH and its staff 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 which 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 the State of Missouri and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal 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, WAIVER, AND INDEMNITY AGREEMENT, KNOW THE CONTENTS THEREOF, AND I SIGN THIS DOCUMENT AS MY OWN FREE ACT.   This is a legally binding agreement which I have read and understand.

Do you Agree to the Application above?
Yes
No

To participate at the Family Fun Centre in Bonne Terre, Missouri, you will need to sign their form as well. Click on the link to complete registration.

https://waiver.smartwaiver.com/w/heuuamf1thuknyd9k2uxap/web/

Have You Signed the Family Fun Centre Form?
Yes
I will fill it out later
No
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