As parent/legal guardian of the child(ren) listed below, I am aware that my child will be involved in an off-campus activity with Washington Avenue Baptist Church and give my permission for the subject of this release to attend this activity. The specific information for this activity is listed below.  Furthermore, I authorize representatives of Washington Avenue Baptist Church to transport my child to the activity.

I understand all reasonable safety precautions will be taken at all times by Washington Avenue Baptist Church and its agents during this activity.  I understand the possibility of unforeseen hazards and know the inherent possibility of risk.  I agree not to holdWashington Avenue Baptist Church, its leaders, employees, and/or volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form.


Merge Student Ministry Gathering.  This event is scheduled for March 1, 2017 and will originate at Washington AvenueBaptist Church and will take place at The River Community Church in Cookeville, TN.  The students will be transported by church van and will leave WABC at 5:15 PM.

Parent/Guardian Name *
Parent/Guardian Name
Emergency Contact Phone *
Emergency Contact Phone
Checkbox *
By checking here, I acknowledge that I consent to the terms of this release of this for my child/children.