Please enable JavaScript in your browser to complete this form.Youth's Full NameFirstLastAge:Guardian's Full NameFirstLastGuardian's EmailStreet AddressAddress Line 2CityPostal CodeEmergency PhoneAlternate PhoneWhen is the best time to contact you?MorningAfternoonEveningWhat is the best way to contact you?PhoneEmailAllergies/health concerns? *Waiver *I agreeI understand that participation in the above event or activity could include those that may be hazardous to the participant named above. By signing below I assume any risk of harm or injury that might occur to the participant due to his/her participation during this event. I release Vineyard Canadian Reformed Church from all liability, costs and damages which might occur. Because the participant is a minor, I agree that the participant has my permission to participate in the event. I further provide my consent for the church to seek medical emergency treatment for the minor if necessary. WebsiteSubmit