Youth Registration – Living Water Fellowship Church

Youth Registration Form

"*" indicates required fields

Youth Event*

Event Date*

Youth Name(s) and Details*

First* Last* Age* Health Card Number

First Last Age Health Card Number

Address*

Street Address Address Line 2 City Province Postal Code

Medical/Allergy/Health Concerns

Parent/Guardian*

Cell Phone*

Emerg. Contact Phone

Print Name as Signature*

Disclaimer: Some youth events are higher risk and involve the possibility of hazard or injury even when following all safety measures. By signing this form you acknowledge that this event may involve a degree of risk, and give consent for your youth to attend. You assume the risk of the event and release the church and staff from all liability. Please have your youth bring their health cards to all events.

Date*

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