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 | Please enter Participant Names in "age-order"
with oldest first and youngest last
1st LOGOS Participant
FIRSTNAME, LASTNAME | | |
Birth Date
MM/DD/YYYY | | |
Grade Level | |
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 | 2nd LOGOS Participant
FIRSTNAME, LASTNAME | | |
Birth Date
MM/DD/YYYY | | |
Grade Level | |
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 | 3rd LOGOS Participant
FIRSTNAME, LASTNAME | | |
Birth Date
MM/DD/YYYY | | |
Grade Level | |
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 | 4th LOGOS Participant
FIRSTNAME, LASTNAME | | |
Birth Date
MM/DD/YYY | | |
Grade Level | |
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 | a Pre-LOGOS program is offered for children in Pre-K and K whose sibling(s) are enrolled in the regular LOGOS at Calvary program.
1st Pre-LOGOS Participant
FIRSTNAME, LASTNAME | | |
Birth Date
MM/DD/YYYY | | |
Grade Level | | |
 | 2nd Pre-LOGOS Participant
FIRSTNAME, LASTNAME | | |
Birth Date
MM/DD/YYYY | | |
Grade Level | | |
 | PLEASE READ AND CHECK BOX BELOW BEFORE SUBMITTING YOUR REGISTRATION
MEDICAL RELEASE AND HOLD HARMLESS
I and/or my child/children, listed on the reverse of this card has/have my permission to attend and to participate in the weekly LOGOS at Calvary events sponsored by Calvary Episcopal Church and School, Richmond, TX 77406 during the fall of 2008 and spring of 2009. I recognize that it is important for my child/children to actively support fellow participants by participating in those activities that they have practiced at LOGOS with the intention of performing in a regular Sunday service at Calvary and will do my best to plan for their participation in those special events. I represent that myself and/or my child/children is/are healthy and capable of participation in said events without causing risk of danger, illness or accident to him/her/themselves/myself, or to others. I agree to hold harmless the LOGOS System Associates, local leaders of the program, leaders of Calvary Episcopal Church and School, volunteers and adults involved, the event coordinators, the Bishop of Texas and the Diocese of Texas in the event of any accident or injury. In the event that either my child/children or I require(s) medical attention while attending these events, I understand that an adult sponsor of the event will make every reasonable attempt to contact me. In the event that I cannot be contacted, I consent to any medical attention deemed appropriate. In the event that treatment is called for, which the medical provider refuses to administer without consent, I hereby authorize an adult sponsor to give such consent for me if I cannot be contacted immediately, or because of an emergency, there is no time or opportunity to make contact. In the event that it is necessary for that person to give consent, I agree to hold such person free and harmless of any liability for damages arising from giving such consent. In order to avoid any complications from such authorization I have listed all allergies, medical problems, and medications currently being taken by participant, or any other pertinent information in the space provided below and will, in writing notify the Registrar of LOGOS at Calvary of any changes in the condition or medications referenced by me. I will also notify the Registrar if/when my child/children or I has/have been exposed to any communicable disease. In addition to the medical considerations mentioned above I hereby grant permission for the LOGOS at Calvary and/or Calvary Episcopal Church and School to use the candid photos of my child or myself taken as part of the events in promotion of the LOGOS at Calvary Program or Calvary Episcopal Church and School. I declare that my child/children/myself is/are covered by medical insurance and/or that I am responsible for any and all expenses incurred by my child/children/myself whether covered under insurance or not. | | |
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