First Presbyterian Church of Farmington, IL

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GradePre-KindergartenKindergarten1st2nd3rd4th5th

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By submitting this form, I give permission to my child to participate in the above named activity and releases First Presbyterian Church of Farmington, its officers, employees, and agents from any liability whatsoever for any injury or death to person or loss or damage to property sustained. In the event I cannot be reached in an EMERGENCY, I hereby give permission to the physician selected by First Presbyterian Church of Farmington to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for my child as named above.

By submitting this form, I agree that any photographs taken of my child at or during this event are the property of First Presbyterian Church of Farmington and may be used in future publications as deemed appropriate.