Mystery Masquerade- YM2 Fundraiser

City Church Lloyd Youth Fundraiser

The youth are raising money to go to a youth convention in May.

Fundraiser

When: Saturday, February 14th

Time: 6:00pm-11:30pm

Ages: 1-12

You can bring all your children!!

Price: Donation only! Give what you can, and if you can not donate, then its on us!

Parent/Guardian Name *

Email *

Phone Number *

How many Kids? *

Kids Names and Ages *

Dietary restrictions(We will have special bracelets for kids with allergies) *

None

Vegetarian

Vegan

Kosher

Gluten-free

Dairy Free

If you have filled out above allergies, please put what kid has the allergy here. *

If you are donating, how will you be donating? (You do not have to donate)

Cash

Debit

Thank you for your help.

I, the parent or guardian of the above child/children above, undertake and agree to indemnify and hold blameless the Ministry Personnel of City Church Lloyd, its pastors and board from and against any loss, damage or injury suffered by child/children from above, as a result of being apart of activities at City Church Lloyd.

I, the parent or guardian of child/ children Above, grant City Church Lloyd, and possible news stations, my permission to use the photographs for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content. Furthermore, I understand that no royalty fee or other compensation shall become payable to me by reason of such use.

I, the parent or guardian of the child/children, In the case of an emergency and City Church Lloyd staff being unable to get ahold/contact parent or guardian, authorize the Ministry of City Church Lloyd to get immediate help from a physician or hospital to provide medical assessment, treatment or procedures for the child/children named above. Until parent/guardian is reached I authorize Ministry of City Church Lloyd to give permissions to physicians or hospital based on their recommendations.

Who, besides yourself, is allowed to pick up your child/children if you are unable to? And who are they to your child/children? Please put their whole name and please let them know they will need ID. Please put First and Last name.

Emergency Contact besides parent above.

Name & Number

Parent or Guardian Signature *

Valentines Day Babysitting!

Valentines Day Babysitting!

Valentines Day Babysitting!