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HILLWOOD PRESBYTERIAN CHURCH

A congregation of the Presbyterian Church (U.S.A.)

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Forms

Connect • Renew • Serve

HILLWOOD PRESBYTERIAN CHURCH

A congregation of the Presbyterian Church (U.S.A.)

Flourish!

GIVE

About Us
Worship
Learn
Serve
Give
Enrichment Opportunities
Connect
Members
Forms

Mahjong Camp Required Waiver

"*" indicates required fields

Step 1 of 2

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Comments

This field is for validation purposes and should be left unchanged.

Name of Participant*

First Last

Age of Participant*

Participant's 1st Parent's/Guardian's Name*

The parents/guardians are the only 2 people legally responsible for the participant and shall be the only two people allowed to check participant in and out to the stated Group Leader.

First Last

Participant's 2nd Parent's/Guardian's Name*

The parents/guardians are the only 2 people legally responsible for the participant and shall be the only two people allowed to check participant in and out to the stated Group Leader.

First Last

Parent/Guardian #1's Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian #1's Email*

Enter Email Confirm Email

Parent/Guardian #1's Cell Phone*

Parent/Guardian #2's Cell Phone*

In the event of an emergency, illness, or late arrival or pick up, the parents/guardians will be contacted by the group leader.*

Check here that the Parent/Guardian #1 and #2 understand and agree to permit Text Message and/or Phone Call.

List any Participant Allergies and Allergic Reactions. If none, type: NONE.*

List any Participant Food or Environment Restrictions and Typical Reactions. If none, type: NONE.*

List any Additional Conditions, Circumstances, or Information for Group Leaders to be aware of. If none, type: NONE.*

Participation Policies & Hillwood Presbyterian Church Required Policies

Hillwood Presbyterian Church’s property is smoke free, drug free, and weapon free.*

Participant and both parents/guardians have read and will abide.

No alcoholic beverages will be possessed or consumed on Hillwood Presbyterian Church property.*

Participant and both parents/guardians have read and will abide.

In the event the participant's or parents'/guardians’ behavior leads to damage, cleaning, or repairs beyond normal and customary use; the parents/guardians shall be billed for and shall pay for expenses incurred.*

Participant and both parents/guardians have read and will abide.

Participants are required to remain with the group and under the supervision of the Group Leader/s during the entire event — from the time the parent/guardian checks in the participant with the stated Group Leader until the time the parent/guardian checks out the participant with the stated Group Leader.*

Participant and both parents/guardians have read and will abide.

Participants and parents/guardians are required to follow directions given by the Group Leader for the benefit and safety of all.*

Participant and both parents/guardians have read and will abide.

Inappropriate behavior and use of the church property by the participant or parents/guardians will be cause for immediate forfeit of participant's continued participation and no refund of fees paid or owed will be returned or waived.*

Participant and both parents/guardians have read and will abide.

All policies posted and unposted shall be observed by the participant and parents/guardians.*

Participant and both parents/guardians have read and will abide.

ALL PARTICIPANTS, PARENTS/GUARDIANS, AND GUESTS SHALL AGREE TO ABIDE BY THESE POLICIES AND RULES. E-SIGNATURES BELOW ATTEST AGREEMENT TO COMPLY.*

Participant has read and will abide all church policies and Group Leader rules.

Parent/Guardian #1 has read and will abide all church policies and Group Leader rules.

Parent/Guardian #2 has read and will abide all church policies and Group Leader rules.

INDEMNIFICATION & HOLD HARMLESS

INDEMNIFICATION/HOLD HARMLESS CLAUSE: the above participant and parents/guardians do personally contract to indemnify and hold Hillwood Presbyterian Church harmless from and against any damages, claim, or demand arising out of the use of Hillwood Presbyterian Church premises by any person participating in, or present because of, the scheduled activity and agree to reimburse Hillwood Presbyterian Church for any expenses incurred defending such claim or demand.

CONSENT/SIGNATURES:*

(This shall act as proof of all participants, parents'/guardians' consent and will act as signatures of the participant and participants' parents/guardians.)

BY CLICKING HERE YOU, THE PARTICIPANT, AND BOTH PARENT/GUARDIAN #1 & #2 ARE AGREEING TO ALL TERMS LISTED ABOVE.

Name of Parent/Guardian Completing this Form*

Date Completed*

ADDITIONAL REQUIRED INFORMATION

Do you give Hillwood Presbyterian Church permission to notify you regarding upcoming events or opportunities to connect, renew, or serve in the neighborhood that may be of interest to you?*

Yes

No

If yes, what is your preferred method of communication (complete all that apply)?

Email

Text

Email

Phone

Photo Permission

To promote events held on the property of Hillwood Presbyterian Church; do you give permission for your child’s, your (parent/guardian #1's), and parent/guardian #2's photo to be used by Hillwood Presbyterian Church? Individual names would not be printed in social media. I grant Hillwood Presbyterian Church and their partners the irrevocable right to use photographs and video or audio recordings of my child, me (parent/guardian #1), and parent/guardian #2 made while participating on the property of Hillwood Presbyterian Church, in any medium, without pay.*

Yes

No

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CONTACT HPC

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6220 HICKORY VALLEY ROAD
NASHVILLE, TN 37205

EMAIL US

615-352-6310

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ABOUT HPC

WORSHIP IN PERSON OR ONLINE WITH US 10:30 AM SUNDAYS.

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