Kids Night April 2023
GAMES AND FUN FOR KIDS K-6TH GRADE.
DINNER IS FREE.
FRIDAY, APRIL 14th, 6PM-8PM
Your First Name
*
Your Last Name
*
Email Address
*
Best contact number
*
Number of children attending
1
2
3
4
5
Mailing City
*
Mailing Zip Code
*
Children information
Child's Name
Child's Date of Birth
Child's School Grade
Pre-School
TK
K
1
2
3
4
5
6
Child's Name
Child's Date of Birth
Child's School Grade
Pre-School
TK
K
1
2
3
4
5
6
Child's Name
Child's Date of Birth
Child's School Grade
Pre-School
TK
K
1
2
3
4
5
6
Child's Name
Child's Date of Birth
Child's School Grade
Pre-School
TK
K
1
2
3
4
5
6
Child's Name
Child's Date of Birth
Child's School Grade
Pre-School
TK
K
1
2
3
4
5
6
Any additional information, such as dietary requirements for any child?
*
Does your Child/Children attend the Henley Youth Center?
*
Yes
No
Do you give The Salvation Army Tustin Ranch permission to release your child from The Henley Youth Center to attend this event?
*
Yes
No
THE SALVATION ARMY - CALIFORNIA SOUTH DIVISION MINOR PARTICIPATION AUTHORIZATION AND WAIVER I am the legal guardian of the children I have register and I authorize them (the participant) to participate in The Salvation Army Tustin Ranch's Kids night. I represent and warrant that the Participant is in good health and of sufficient physical fitness to participate in the Activity, and I do not know of any physical condition which would prevent the Participant's participation, cause harm to the Participant, or cause harm to others. I understand that participation in the Activity places the Participant at risk for serious personal injury, including death, and loss resulting from any number of factors including, but not limited to, the physical condition of the facility, use of equipment, weather that may be experienced, and conduct of other participants. In addition, the Activity poses the following specific risks: broken bone, cut, laceration, scrape, or head injury including, but not limited to, those to the face or mouth. In consideration for the Participant's opportunity to participate in the Activity, I agree on behalf of myself and on behalf of the Participant, as well as our estates and assigns, to relieve The Salvation Army and its officers, directors, employees, volunteers, and agents from any and all liability, including without limitation negligence, in connection with any injury, loss, or damage to person, including death, or any injury, loss, or damage to property in connection with Participant's participation, to the maximum extent permitted by law. I on the behalf of the Participant irrevocably grant to The Salvation Army, its successors and assigns, Its agents and it is commissioned, the absolute, unrestricted and unlimited license, right, permission, and consent to use and reuse, disseminate, copyright, print, reproduce, publish and republish, for any and all trade purposes or commercial or other advertising or public purposes, and in any and all advertising, publicity, display, publication or media, my name, signature and likeness, and any portraits, pictures, photographic prints of other representations of me or in which I may appear, or any reproductions or sketches thereof or parts thereof, photographic or otherwise, with such additions, deletions, alterations or changes therein as you in your discretion may make, either separately or together with my name or a fictitious name, or the name of another person, with or without my statements of testimonials made by me, or authorized by me which you may, In your discretion, prepare for use connection therewith. I warrant that I have not limited or restricted by the use of my name, photograph or film likeness to the use of any organization or person. I hereby grant unrestricted use of audio tracks for text by The Salvation Army for such purposes, as The Salvation Army may deem appropriate. I hereby authorize the employees, volunteers, and agents of The Salvation Army to provide reasonable and necessary emergency medical treatment for the Participant while the Participant is participating in the Activity, if The Salvation Army determines in its discretion that such treatment is necessary. I further agree to pay for any such reasonable and necessary medical treatment upon presentation of the medical provider's bill or statement. I accept full financial and legal responsibility for the Participant's conduct during participation. I understand that by agreeing to this Participation and Authorization Waiver, I give up my right and the Participant's right to sue The Salvation Army. I agree that if any provision or part of any provision or the application of such is held invalid, illegal, or unenforceable, the validity of all other provisions in this Participation and Authorization Waiver shall remain unaffected.
I have read and agree
Salvation Army Tustin Ranch
10200 Pioneer Road, Tustin
Submit