Register for Kids Service Week (May 29 - June 3) by filling out the information below. Please fill out separate forms for each child you are registering. Thank you!
Since we will be transporting your child, we must also ask for their Health Insurance Information (in the event of an emergency).
In registering my child for this event, I hereby grant my child (named above) permission to attend and participate in the Kids Service Week of Southside United Methodist Church (hereinafter referred to as SUMC). I agree that the attendance of my child at this event constitutes my agreement with and acceptance to the terms of this release. I agree that my child's picture or likeness may be included in any photographs or vidoes taken at the event.
I accept full responsibility for my child's actions, and I hereby indemnify and hold harmless SUMC, the Mountain Lakes District and the North Alabama Conference of the United Methodist Church, against any and all loss or damage arising from any and all accidents or injuries caused by my child, whether accidentally or willfully, to: (i) property owned by SUMC; (ii) property of those acting as employees, agents or assigns (including, without limitations, volunteers) of SUMC; and (iii) personal injuries or death suffered by any employee, agent, volunteer or staff member of SUMC.
I further accept responsibility for my child's safety and I hereby release, hold harmless, and agree to indemnify and defend SUMC, its agents, employees and assigns, including, without limitation, volunteers and staff, from and against any and all damages arising out of, relating to or resulting from my child's participation in Kids Service Week, except to the extent wholly cuased by the gross negligence or intentional misconduct of any such volunteer(s) or staff.
In the event of injury to or illness of my child while engaged in Kids Service Week, I hereby expressly grant to SUMC, its agents, employees and assigns, permission to seek such medical care (including emergency treatment) as any of such persons reasonably believe is needed, based on their good faith assessment of all attendant facts and circumstances, and I hereby agree to indemnify and hold harmeless SUMC, together with the Mountain Lakes District and the North Alabama Conference of the United Methodist Church, from all expenses incurred in obtaining medical treatment for my child.