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Event Registration

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Fusion 2019 on Friday, January 18, 2019

50.00
Student Information
*Gender:
*Grade:
Name of Small Group Leader:
*Which Campus do you attend:
*Do you have any allergies:
If so, please list them here::
Parent Information
*Parent's Name?:
Parent's Cell Phone?:
Second Option Phone Number?:
*I give permission for my student to register for Fusion Weekend.  I do hereby release, acquit, hold harmless and forever discharge Faith Promise Church, its agents, servants, and employees, and all persons, natural or corporate, in privity with them or any of them, from any and all claims or causes of action of any kind whatsoever, including but not limited to actions, suits and/or claims for any bodily injuries, death or property damage which may be sustained by my student while participating in any activity, or activities, including travel to from, and during such activities and any negligence or lack of care due or claimed to be due to the conduct of any agent, servant, or employee of Faith Promise Church.   I understand that my payment of $50 is non-refundable
I agree to the above statement *
*Parent's Email?: