Ocean Commotion at The Ark Montebello

Family Information

Parent/Guardian First Name

Parent/Guardian Last Name

Primary Phone

Address

Street

Street 2

City

State/Province

Postal Code

Emergency Contact

Relationship to Student

Phone Number

Part 1 of The Ark's Liability Release Form (Please check each box)

I am aware that during The Ark practicum, certain risks & dangers may occur which are out of the control of The Ark Montebello &/or its organizers.

I assume all the risks & will hold The Ark & its affiliates, workers, and employees harmless from any liability, actions, suits, legal, or otherwise.

Part 2: Under no circumstances will The Ark Montebello &/or its organizers be held responsible for: (Please check each box)

Baggage damage, loss, or delay

Delays, personal injury, property damage, or any loss resulting from so-called "Acts of God," act of public enemies, arrest or restraint of any government, seizure under legal process

Quarantines, restrictions, riots, civil commotions, strikes, war hazards or terrorists activities, illness, death, accidents or injury

Illness, death, accidents, or injury

Loss of personal property, possessions or monies

Any act of neglect of any person or company whose services are retained by The Ark Montebello for the benefit of our practicum

Any deviation, delay, or curtailment of any kind which is beyond the control of The Ark Montebello

Additional expenses, if incurred under any of the above circumstances are the responsibility of the tour participant (yourself)

Part 3: Liability Release Form--By checking the boxes, I agree to the terms and conditions.

I hereby also acknowledge the fact that The Ark Montebello and any of its workers, &/or employees have the right to terminate my participation in this practicum, at any time...

because of health, unwarranted conduct, or any other reason they deem harmful or detrimental to the group as a whole.

Part 4: Photo Release Please be advised that our church photographers may be taking pictures during our VBS week for The Ark's website and social media only. Should your child's photo be used, his/her name will not be identified. Also, we will be taking a picture of all kids for a craft. We will print out one copy. All photos will be deleted on the last day of VBS.

Student Information

First Name

Last Name

Gender

Male

Female

Birth Date

Age Group

5 yr olds/Kinder

1st/2nd Grades

3rd/4th Grades

5th Grade

Special Needs who will need a one to one assistant

T-Shirt Size

Youth X-Small

Youth Small

Youth Medium

Youth Large

Youth X-Large

Adult Small

Adult Medium

Adult Large

Adult XL

Food Allergies

Details

Medical Concerns

Details

Custody Instructions

Details

Photos Allowed

I have more students to register

Register for VBS

at The Ark Montebello

Family Information

Address

Student Information