ECOBYOUTH Connection Sunday Liability Release Form 2026

ECOBYOUTH Connection Sunday Party Liability Form

On Sunday, September 13th, ECOBYOUTH will host a Connection Sunday party as our way to kickoff the school year of events and activities! We have inflatables, a water slide, games, food, and more!

Please fill out this liability form so that your youth can join us on the inflatables!

Participant's Information

First Name *

Last Name *

Date of Birth *

Gender

Mobile Number

Parent/Guardian Information

Must be filled out if the participant is a youth (5th-12th Grade).

Parent/Guardian First and Last Name *

Parent/Guardian Phone Number *

Parent/Guardian Email *

I, the undersigned parent/guardian (or self if over 21) do hereby grant permission for my child to attend all events hosted by Ephrata Church of the Brethren (ECOB). I hereby authorize the event staff to obtain and consent to medical treatment for my child in case of injury or illness during events. I hereby release and discharge all event staff and ECOB and its representatives, employees, volunteer staff, and agents from any and all debts, judgments, or suits of any kind which may arise or be occasioned as a result of the participants participation in the events with ECOB. I further acknowledge and understand that by participating in the events there is a possibility of physical injury and my child (or self) is assuming the risk for such illness or injury by his/her/my participation. It is my understanding that payment of any medical bills will be paid by me or by my insurance company.

Type your full name as a signature.

Signature *

Today's Date *