Personal Information

Please list each child's name and age. *

Waiver and Release

The undersigned is the parent or authorized legal guardian of the children previously listed,

(“Participant(s)”), a minor child that is attending Touch a Truck (the “Event”) at the The Preschool at Second-Ponce (The Preschool) on the campus of Second-Ponce de Leon Baptist Church (SPdL) and has voluntarily chosen to participate in the Event. The undersigned understands and acknowledges that (1) Participation in the Event includes activities that may expose Participant to risks of injury (or even death); (2) that the undersigned must accompany Participant at all times during the Event; (3) the undersigned is responsible for ensuring that the Participant follows all safety rules related to the Event; and (4) as a condition of participation in the Event, the undersigned gives permission for The Preschool at Second-Ponce and its sponsors to use photographs taken at the Event, which may include photographs of Participant, to be used in program newsletters or any other promotions or publications.

 

As a condition to permitting Participant to participate in the Event, The Preschool at Second-Ponce and its Event sponsors, have asked the undersigned parent or authorized legal guardian, on behalf of the Participant, to sign this Waiver Form and Release of Claims.

 

Therefore, the undersigned, on behalf of himself/herself, Participant, and Participant’s heirs and legal representatives, fully, completely and unconditionally releases The Preschool at Second-Ponce and Second Ponce de Leon Baptist Church staff and governing Board members, respective officers, directors, employees, and agents and all companies and organizations supplying trucks and other vehicles for the Event, and any of their officers, agents and employees (collectively, the “Released Parties”) from and indemnifies the Release Parties against all claims that the undersigned, Participant and his/her heirs and legal representatives might have or assert for liability arising directly or indirectly from or relating in any way to the Event or injuries suffered by the Participant during or as a result of the Event.

 

The undersigned understands and acknowledges that this Waiver Form and Release of Claims prevents the undersigned and Participant, including any other heirs and legal representatives, from suing the Released Parties because of injuries or death resulting directly or indirectly from the Event.

 

By his/her signature below, the undersigned acknowledges that he/she has read, understands and agrees to this Waiver Form and Release of Claims.
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Payment Information

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If your total is correct, please submit your form and you will be directed to PayPal to complete your registration. When you arrive on the day of the event, proceed to the line marked "Pre-registered" to receive your wrist bands. If you have questions about the event or are having difficulty completing this form, please contact Dorsey DeLong at ddelong@spdl.org