Top
Westlake Church
Home About Celebrate Connect Contribute What's Happening Sign Up Forms Resources Directory
GIVE
HomeAboutCelebrateConnectContributeWhat's HappeningSign Up FormsResourcesDirectory
Westlake Church
GIVE

 

Student Name *
Parent/Guardian Name *
Emergency Contact Name *
Emergency Contact Number *
I recognize that there are risks involved in participating in this activity and hereby assume all risk of injury, harm, damage, or death in connection with my participation in this activity. I understand and agree that neither Westlake nor its trustees, officers, directors, employees, agents or representatives may be held liable in any way for any injury, harm, damage, or death that may occur to me as a result of my participation in this activity and hereby release Westlake, its trustees, officers, directors, employees, agents and representatives from any injury, harm, damage or death, which may occur while I am participating in the activity. To the fullest extent permitted by law, I agree to save and hold harmless Westlake, its trustees, officers, directors, employees, agents and representatives from any claim by myself, my estate, heirs, successors, assigns or other persons arising out of my participation in the activity. I understand and acknowledge that Westlake does not provide health or medical insurance in connection with the activity and I agree that I will be financially responsible for any bills incurred as a result of medical treatment, including emergency medical treatment and/or transportation to a medical facility, in connection with my participation in the activity. Please add today's date in the box below.
Release *

Thank you!

Westlake Church

6696 Rockville Rd. Indianapolis, IN 46214

(317) 241-9451
info@wl.church

Info

Service Times
Celebrate
Connect
Contribute
Resources

I'm New

Sign up to receive news and updates.

Thank you!
Service Times & LocationVBS RegistrationSign Up Forms (Copy)