Child's Name
Parent/Guardians's Name
I give permission for my child to be picked up at Central Elementary School to participate in Headwaters After School Care at South River Baptist Church.
I am fully aware that my child will be transported from Central Elementary School to South River Baptist Church. I have previously completed a Medical/Liability Release Form for my child. By signing this permission slip, I am confirming that the information on his/her Medical/Liability Release Form is current and up to date. I understand in the unlikely event of an accident or emergency that my child will receive adequate care based upon the information given. I assume all risks, hazards and incidentals involved in the conduct of the activity. I do hereby release, indemnify and hold harmless Headwaters Christian Academy and South River Baptist Church from any and all loss, injury or other damage arising out of this activity. I understand the inherent risks in any travel, and agree to waive any and all liability on behalf of the referenced organizations for those risks.