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4805 Bonnie View Rd Dallas, Texas | (214) 375-3061
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THEME: CELEBRATING JESUS
WEDNESDAY THRU FRIDAY: JULY 17TH-19TH | 6:30 PM – 8:30 PM
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Waiver
In consideration for the privilege of allowing my child to participate in the above-named activity, I agree to release and hold harmless the Zion Missionary Baptist Church, its officers and agents, from any liability to or responsibility for bodily injury, damage or illness to the above-identified child while participating in any youth athletic or social activity which may be directly or indirectly sponsored by ZMBC. Further, I agree to indemnify and hold harmless the Church, its officers and agents with respect to any claim asserted by or on behalf of my child as a result of bodily injury, illness, or damage.
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Child Grade Level
Child Gender
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Parent or Guardian Name
*
First
Last
Address
Address Line 1
City
--- Select state ---
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District of Columbia
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Zip Code
Email
Contact Phone Number
Do you give your permission to Photograph Your Child?
Yes
No
Are You a Member of Zion MBC?
Yes
No
Do your Child have any allergies or take medication? If so state what type in comment.
Yes
No
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