WF Wednesday Walk to Kimmer's Night Permission Form                                             - TO BE COMPLETED BY PARENT
Wednesday, June 16, 2021
7:00-8:30 p.m.
MEET AT CHURCH and we'll walk to Kimmer's (pitstops at Starbuck's allowed!), hang out for a bit, and walk back!
Bring comfy shoes and $$ for your ice cream!

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Meet at church at 7pm!
I am the parent. (Only a parent should complete this permission form). *
Limiting activities (Activities your student should not participate in.)
Permission (continued)
I, on behalf of myself and my child, (the “Indemnifying Parties”), hereby indemnify, release, hold harmless, covenant not to sue and forever discharge, to the fullest extent permitted by law, the First Presbyterian Church of Wheaton (the “Church”) and its related incorporated or unincorporated entities, affiliates or connectional organizations, their agents, employees, officers, directors, affiliates, volunteers, successors, and assigns, (each an “Indemnified Party”) of and from any and all claims, demands, expenses, personal injury, wrongful death, causes of action, lawsuits, damages, (including punitive, special,  consequential, indirect, exemplary or incidental damages (the “Claim’ or Claims”), losses, actual attorneys fees, costs, expenses, liabilities and settlement amounts (“Loss” or “Losses”) and liabilities of every kind and nature, whether known or unknown, in law or equity that I or my child ever had or may have arising from or out of or directly or indirectly related to my child’s participation in any programs, youth programs, trips, retreats or activities, sponsored or conducted by, on the  premises of, or for the benefit of the Church regardless of when the Loss or Claim is asserted, provided however, that the Indemnifying Party  shall not have any obligation hereunder in respect of Losses or Claims incurred or asserted solely by reason of the gross negligence or willful misconduct of the Indemnified Parties.

I have had an opportunity to ask questions about the above listed activity (ies), and any questions I have asked have been answered to my complete satisfaction. The nature of the activity(ies) has already been fully disclosed to me and I have had the opportunity to decline participation.  I understand the risks of my child’s participation in this activity and knowing and appreciating these risks, I voluntarily choose to allow my child to participate, assuming all risks of injury or death due to my child’s participation.

This Permission and Release and its various exhibits and attachments, is governed by the laws of the State of Illinois and is intended to be as broad and inclusive as is permitted by law.  If any provision of this Permission and Release  is held invalid or unenforceable by a court of competent jurisdiction, the remaining provisions will continue to be fully effective.  This Permission and Release contains the entire agreement between the parties and  may not be modified except in writing, signed by the Parties against whom the proposed modification is asserted. In the event that I cannot be reached, I authorize and direct any adult activity sponsor or group leader  or other representatives of the Church to obtain emergency medical treatment for my child and I agree to be financially responsible for such medical care. I have completed and attached the Transportation and Medical Release Consent Form.

I also give my permission for my child to be photographed during this program and understand that the pictures may be used for publicity purposes in the local media, for church publicity and on the church website.

I am the parent of legal guardian of the below named child/children, am of lawful age and legally competent to sign this Permission and Release.  I understand the terms of this Permission and Release and I have willingly signed it of my own free will.
Name of Child/Children *
Parent/Legal Guardian *
Relationship *
Cell Phone Number *
Additional Emergency Name and Cell Phone Number *
Parent/Legal Guardian Electronic Signature *
Date *
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