Parents Name / Nombre de los Padres
*
* indicates a required field (campo requerido)
First Name
Last Name
Email Address / Direccion de Correo Electronico
*
If you attend a local church, which church do you attend? If you attend a campus of the church, which one? / Si asistes a una iglesia local, ¿a qué iglesia asistes? Si asistes a un campus de la iglesia, ¿cuál?
Select Number of Children in Care / Seleccione el Numero de Ninos de Crianza en el Hogar
Foster, Guardian/Kinship, etc... Please complete the following fields below for each child in care. / Por favor complete los siguientes campos para cada nino bajo cuidado.
Select the age range / Seleccione el rango de edad
Select the age range / Seleccione el rango de edad
Select the age range / Seleccione el rango de edad
Select the age range / Seleccione el rango de edad
Select the age range / Seleccione el rango de edad
Select the age range / Seleccione el rango de edad
Biological Children / Hijos Biologicos
Depending on supply, we may be able to provide gift boxes to biological children in the foster family. Please include gender and age-range information below if this is applicable to you. / Dependiendo de la oferta o abastecimiento, es possible que podamos proporcionar cajas de regalo a los ninos biologicos de la familia de acogida. Por favor incluya la informacion, abajo, de genero y rango de edad si esto es aplicable a usted.
Waiver & Release of Liability
*
WAIVER AND RELEASE OF LIABILITY
By registering for this event, I agree to this waiver, I, the registrant, acknowledge and agree to the following terms and conditions in connection with my participation in Project You Belong, organized by Child Hope Services, Gateway Church, and Haven Ranch (“the Organization”).
Assumption of Risk: I understand that my participation in the event involves certain risks and may include, but is not limited to, risks of personal injury, property damage, or other harm. I voluntarily assume all such risks, whether known or unknown, and take full responsibility for my participation in the event.
Release of Liability: In consideration of being permitted to participate in the event, I hereby release, discharge, and hold harmless the Organization, its officers, directors, employees, volunteers, agents, sponsors, and affiliates from any and all claims, demands, or causes of action arising out of my participation in the event, including, but not limited to, any injury, illness, or damage to property, whether caused by the negligence of the Organization or otherwise.
Medical Treatment: I hereby authorize the Organization to seek and obtain medical treatment on my behalf in the event of injury or illness during the event, and I agree to bear all costs associated with such treatment.
Publicity: I grant the Organization the right to use any photographs, videos, or other media taken during the event for promotional, educational, or fundraising purposes, without compensation or notice.
Compliance with Event Rules: I agree to comply with all event rules and regulations and to follow any instructions or directions provided by the event organizers and volunteers. I understand that failure to do so may result in my removal from the event.
Indemnification: I agree to indemnify, defend, and hold harmless the Organization from and against any claims, losses, damages, or liabilities, including attorney’s fees, arising out of my participation in the event or any breach of this waiver.
Severability: If any provision of this waiver is deemed invalid or unenforceable, the remaining provisions shall continue in full force and effect.
By checking the box below, I acknowledge that I have read and fully understand this waiver and release, and that I am voluntarily agreeing to its terms.
