Youth SignupMiddle School Thunder Road TripWhen: June 11, 6:30pm-8:30pmWho: Trinity 6-8th graders and FRIENDSCost: $10 + slip due by June 1stWhere: 2902 Thunder Rd S, Fargo, ND We are going to play a round of mini golf and race each other on the go cart track. Ask your parents or another adult to come and chaperone! Please return this slip and $10 by Sunday, June 1st or contact Crystal (crystal@trinitymhd.org or 218-477-3427) ONLY if you are committing to going. Your FRIENDS also need to turn in a permission slip and $10 by June 1st Attendee Name Grade Liability & Media Release The attendee named above has my permission to participate in the Thunder Road Trip, June 11, 202, from 6:30 – 8:30pm at Thunder Road in Fargo. I recognize that there are risks involved in participating in this activity with Trinity Lutheran Church and hereby assume all risk of injury, harm, or damage to my minor child as they participate in this activity. I hereby release and agree to hold harmless Trinity Lutheran Church and its employees, organizers, and any volunteers assisting in the program, from any and all liability and claims arising out of my child’s participation in programs and related activities. I hereby release Trinity Lutheran Church, its staff and sponsors, from responsibility and liability for any injury or illness that my child may sustain during the event. In case of emergency, where I cannot be reached, I hereby authorize Trinity Lutheran Church to administer necessary first aid or seek emergency medical attention for my child. I hereby authorize an adult leader of this event, as agent for me, to consent to any x-ray examination; medical, dental or surgical diagnosis; treatment; and/or hospital care advised and supervised by a physician, surgeon, or dentist (as appropriate) licensed to practice under the laws of the state where the services are rendered, either at the doctor’s office or in any hospital. I expect to be contacted as soon as possible. I understand that I am responsible for the health care decisions of my minor child and agree that my insurance plan is the primary plan to pay for the medical, dental, or hospital care or treatment that is given to my minor child. I give my permission for my child to be photographed/videotaped. I understand that the images may be displayed in church publications, church building, website and/or social media. I understand that as a precaution, my child’s names will NOT be published or linked with photographs. Name of Parent/Guardian Parent Email Parent Phone Number Parents/Guardians: Would you be willing to chaperone this trip? Yes No Emergency Information: In case of emergency, please contact(only when parent or guardian cannot be reached). My Child was invited by Submit
