Chinese Bible Church of Greater Lowell
197 Littleton Road, Chelmsford, MA 01824
978-256-3889
Permission given? Please READ:
By filling out this online form I give the church permission to retain the information given here in its records and to update the church if there is any change. The church is hereby given 8 and permission to furnish any necessary transportation, food and lodging for the Participant in connection with the named activity. I understand that, in the event a medical intervention is needed for the Participant, reasonable attempts will be made to immediately contact me. In the event that I or the alternate contact cannot be reached, I hereby give my permission to secure medical treatment for the Participant as necessary, including but not limited to emergency surgery or treatment, and I will assume the responsibility of all medical bills, if any. Should it be necessary for the Participant to return home due to medical reasons, disciplinary action or otherwise, I hereby assume all transportation costs. I and on behalf of the Participant, hereby assume all risk of personal injury, sickness, death, losses, damage and expenses of any nature whatsoever which may be incurred by the undersigned and the Participant while participating in the above event, and any work, activities and recreation involved therein; and agreed to hold the Church, its officers, staff, co-workers, and volunteers harmless, and release and forever discharge them from any and all liabilities, claims or demands in connection therewith. I hereby also further agree to hold harmless and indemnify the Church, its officers, staff, co-workers and volunteers for any and all liabilities sustained by the church as a result of negligent, willful or intentional acts of the Participant, including expenses incurred in connection therewith. I give permission for my child to attend the LYF Retreat from October 6-9, 2023. I understand that the total cost of $250 is due September 17, 2023. Should my child be unable to attend due to family or medical emergency, I will be refunded the full retreat cost. I also understand that limited scholarships are available at my request. By filling out this form for/with my child, I acknowledge that I have read and understand the above and that I accept the conditions contained herein. I also represent through this form, a signature on behalf of the named Participant, I am the parent/legal guardian of the Participant, allowing them to participate in LYF Retreat 2023.
Date/Times: LEAVE from Church Friday, October 6th (6:00 pm) – Return Monday, October 9th (3:00 pm)
Transportation: Bus
Place: Camp Spofford: 24 NH-9A, Spofford, NH 03462
(603) 363-4788; http://www.campspofford.org/
