For the safety of the children, ONLY the names of adults listed below will be allowed to check a child in & out of the children's ministry area at UP City Serve and a government issued photo ID will need to be shown to prove identity:
Please read before submitting:
Thank you for completing this form! It is our desire to keep every child in our care safe in every possible way, however, unexpected things can happen. By the submission of this form, named Parent / Guardian agrees to and accepts the following:
UP City Serve Parent / Guardian Disclaimer – Release of Liability:
1. I am voluntarily checking in my child(ren) to the children's ministry area at UP City Serve. I understand that for the ENTIRE duration that my child(ren) is checked in to the children's ministry area at UP City Serve there will be at least one Parent / Guardian / Approved Adult named on this form PRESENT on the UP City Serve / Lower Harbor park grounds and will be available immediately to the children's ministry area volunteers via text, phone call, or in person contact. If no listed Parent(s) / Guardian(s) or adult(s) listed, who are allowed to check the child in and out, are available to the child(ren) at any time while checked in within a 15-minute attempted notification (via phone call, text, or in person contact) and/or are found to not be on the UP City Serve / Lower Harbor Park grounds, police will be notified.
2. I, the parent / guardian, release and hold harmless UP City Serve and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my child participating in the children's ministry area at UP City Serve.
3. I understand that this Waiver discharges UP City Serve from any liability or claim that I may have against UP City Serve with respect to bodily injury, personal injury, illness, death, or property damage that may result from my child(ren)'s participation at UP City Serve.
4. I also fully understand that UP City Serve does not assume any responsibility for or obligation to provide financial assistance or other assistance, including, but not limited to, medical, health, or disability insurance, in the event of injury, illness, death or property damage. I hereby release UP City Serve from any claim whatsoever which arises or may arise in the future due to any first aid treatment or other medical services that are conducted in connection with an emergency during my child(ren)'s time at UP City Serve.
5. I grant unto UP City Serve all rights, title, and interest in any and all photographic images and video or audio recordings that are made during UP City Serve that may include my child(ren) participating in the children's ministry area at UP City Serve: including, but not limited to, any royalties, proceeds, or other benefits that are derived from such photographs or recordings.
6. I expressly agree that this Waiver is intended to be as broad and inclusive as permitted by the laws of the State of Michigan, that this Waiver shall be governed by and interpreted in accordance with the laws of the State of Michigan, and in the event that any clause or provision of this Waiver shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.
By the submission of this form I, Parent / Guardian of listed Child(ren) state that all information is correct and not misleading in any way. I agree with and will uphold UP City Serve's disclaimer / release of liability.
