PERMISSION SLIP FOR LOCK-IN AT AAFC

FRIDAY 10-21-05 THRU SATURDAY 10-22-05

(7 PM-10 AM)

(If you are not staying overnight you will need to leave the church by 10:30 PM, this is to ensure your safety!)

While the staff at Asian American Fellowship Church will make every reasonable effort to watch and oversee my child while at the church lock-in/staying overnight, I acknowledge that all incidents associated with activities cannot be foreseen.

I hereby release and discharge Asian American Fellowship Church, its officers, directors, employees and agents from any claims, causes of action, costs, obligations or financial responsibility resulting from or arising out of any accident occurring while my child is participating in activities at AAFC.

If AAFC is held financially responsible to or for my child for any such incident, injury or accident, I agree to indemnify and hold harmless, AAFC from any such responsibility including costs, damage, and attorney fees incurred by AAFC.

*For more information please contact Luna at (515) 770-3498 or (515) 279-0876 church phone*

YOU MUST BRING THIS SIGNED PERMISSION SLIP ON FRIDAY 10/21

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Name of person staying overnight at the church

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