Note: This is an archived version of the page from nhlc.org related to North Heights Lutheran Church.

Source Details

Entity: North Heights Lutheran Church

Source: nhlc.org

Source URL: http://nhlc.org/597768.ihtml

Archive URL: http://web.archive.org/web/20101127232916/http://nhlc.org/597768.ihtml

Archive Datetime: 2010-11-27T23:29:16

North Heights Lutheran Church

THE BODY AT WORK, TAKING GOD’S POWER TO THE WORLD

elements Fall OVERFLOW Retreat Registration & Medical Release

Name Gender

Phone Number

Address

City    State    Zip

Email

Emergency Contact

Emergency Contact Phone

Please note below any medical information we should be aware of:

I, waive, release, and indemnify the North Heights Lutheran Church and its ministers, agents, directors, officers, employees, and volunteers from all demands, claims, or liability, in law or in equity which has arisen or which may arise from any North Heights Lutheran Church activity or trip and which involves any damage, loss, or injury to me or my property. This consent, medical authorization, and release is revocable only by writing signed by me which bears the date that the revocation is delivered to the North Heights Lutheran Church. (NOTE: This box must be checked to register for this retreat.)

 

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