Lost Island Water Park

Student Name

Grade 26-27

5th 6th 7th 8th 9th 10th 11th 12th 2026 Graduate

Parent(s) Name

Parent Phone Number

Parent Email

This address will receive a confirmation email

I understand that my child will participate in a church-sponsored youth trip that may involve road travel, physical tasks such as water slides and floats, and food consumption. I acknowledge that all such activities carry certain inherent risks, including but not limited to travel-related accidents, physical strain or injury related to water activities, and unforeseen circumstances. I hereby give permission for my child to attend and participate in this event, including transportation to and from Lost Island Waterpark in theStone Church van. Please initial.

In consideration for theStone Church allowing my child to participate in this event, I, the undersigned parent or legal guardian, on behalf of myself, my child, and our respective heirs, assigns, and personal representatives, hereby: Release, waive, discharge, and hold harmless theStone Church, its pastors, staff, volunteers, drivers, and representatives from any and all claims, demands, damages, losses, or liabilities arising from or in connection with my child’s participation in this event, including travel to and from the waterpark. Please initial.

In the event of an emergency where I cannot be reached, I authorize theStone Church staff or designated adult leaders to obtain necessary medical treatment for my child. I accept full responsibility for all medical expenses incurred. Please initial.

Medical conditions, allergies, or medications we should be aware of:

I grant permission for my child to be photographed or recorded during this event for use by theStone Church in print or digital media. Please initial.

Payment $18

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

August 4th

On August 4th, theStone Church Student Ministry is heading to Waterloo for a fun day at Lost Island Water Park. We will leave the church at 9:30 am and will return by 8:00 pm. This event is for 5th grade-graduating seniors. The price for this event is $18. This includes admission and transportation.

Lost Island Water Park

Description

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