My child has my permission to participate in the 567 Retreat with Connect 567 Ministry. I also give permission for the student named above to participate in all activites associated with the above activity. I understand all reasonable safety precautions will be taken at all times by the Connect Church and its agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Connect Church, it’s leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form. In case medical help is needed, I give my permission to appropriate staff and adults of Connect Church to get appropriate treatment from a licensed physician, in the event that I cannot be reached at the numbers found below.

One of our activities will be at 'The Wall' here in Russellville. The Wall is a climbing gym. To give your child permission to participate in this activity, this form must be completed. Please make sure this is turned in to a 567 leader before the retreat.