Inspire the Fire

ITF Participant Permission Slip

PERMISSION SLIP

I hereby give permission for my child_________________________ to travel with Inspire The Fire to __________________________ from _____________to _________ on _____________________. We will be returning at approximately ______________. Please meet us at ___________________________ to pick up your child upon return. If we are running behind you will be contacted immediately. If you have any additional concerns or questions, feel free to contact me at 704–258-9811. Thanking you in advance for your support and efforts!

Mr. Dennis Reed Jr.

Director of Inspire The Fire

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Policy and Liability Waiver

PARTICIPANT HOLD HARMLESS: As a condition of participation in this program, the undersigned agrees that in the event of disablement, injury or diseases of a temporary or permanent nature incurred by the participant while in the program, that all claims of liability are waived against Inspire The Fire Inc., The Director, Board Members, Counselors or Volunteers thereof and the undersigned does hereby assume said risks as one of the ordinary risks of participation in said program, and consequently holds the Director, Inspire The Fire Inc., and it’s Board Members, Counselors or Volunteers, harmless in the event of disablement injury or disease named by the undersigned in the program.

Parent Signature____________________________ Date: _______________