Youth Escape Room: Off-Site Activities Consent

Thursday, March 19, 2025 7:15 pm- 9:30 pm | Centreview Church is planning an activity that requires your permission prior to participation. We have provided you with the details of the activity and request that you complete and sign the permission form. The safety of your child is our primary concern. Precautions will be taken for their wellbeing and protection. Thank you in advance for your partnership.
DESCRIPTION OF ACTIVITY

Activity: Youth Outing
Date: March 19, 2025
Time: 7:15 pm - 9:30 pm

Drop Off: Hinthunt Escape Rooms - 790 Burnhamthorpe Road W Unit #4, Mississauga at 7:15pm

After the escape room, students will walk with their leaders to the McDonalds in the plaza. 

Pick Up: McDonalds - 796 Burnhamthorpe Road W, Mississauga

Activity Details: Students will be going to an escape room to build community and have fun together . Parents/guardians will be responsible for dropping off and picking up their child at the above location.
Cost: $30 per person - this cost is NON-REFUNDABLE. If students also wish to purchase food at McDonalds, they should bring extra money to do so. 
Personal information

 
 
Emergency Contact

 
 
 
 
Informed Consent

While every precaution is taken for the safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at Centreview Church.  I understand and accept these risks and agree that by allowing my child to participate in those activities, he/she may be taking part in a recreational activity that presents the potential for personal injury.

I, the parent/ guardian named below, authorize the Youth Pastor or one of Centreview Church Ministry Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

I, the parent/ guardian named below, undertake and agree to indemnify and hold blameless Centreview Church, its Ministry Personnel, its Pastors and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Centreview Church,  as well as of any medical treatment authorized by the supervising individuals representing Centreview Church.  This consent and authorization is effective only when participating in or traveling to and from events of Centreview Church.

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Payment

$30 CAD
 
 
 
 
 
 

Description

Thursday, March 19, 2025 7:15 pm- 9:30 pm
Centreview Church is planning an activity that requires your permission prior to participation. We have provided you with the details of the activity and request that you complete and sign the permission form. The safety of your child is our primary concern. Precautions will be taken for their wellbeing and protection. Thank you in advance for your partnership.