When

Saturday, February 5, 2022 at 9:00 AM CST
-to-
Sunday, February 6, 2022 at 12:00 PM CST

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Where

Children's Harbor at Lake Martin

Contact

Bigtime Ministries
Bigtime Ministries
janie@bigtimeministries.com

Replace Retreat

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Student Information

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    Grade:

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    Please select a payment method:

  • Fee

    Type Fee
    $185.00

Parent Information

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Important Information

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Parental Consent & Waiver

  • *Required by Bigtime Ministries. The following statements must be read and agreed to by electronic signature below. Parents of said minor, do hereby agree and acknowledge as follows:

  • 1. Said minor has permission to attend and participate in any activity officially sponsored by Bigtime Ministries from February 5th–6th, 2022.

  • 2. The undersigned does also hereby give permission for our (my) child to ride in any vehicle designated by the adult in whose care the minor has been entrusted while attending and participating in the aforementioned activities.

  • 3. The undersigned authorizes Bigtime and any adult in whose care our (my) child has been entrusted, to consent to any x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care, to be rendered to my child under the general or special supervision and on the advice of any licensed physician or dentist, whether such diagnosis or treatment is rendered at the office of said physician or at a hospital. Attempts will be made, whenever possible and practicable, to reach you at the numbers listed below before such treatment is given.

  • 4. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to our (my) child pursuant to this authorization.

  • 5. If the undersigned's minor child should suffer an injury or illness as a result of or arising out of any activity sponsored by Bigtime including, but not limited to, injuries occurring as a result of transportation activities, the undersigned, for ourselves and for our minor child, do hereby release, absolve and discharge Bigtime and Children’s Harbor of and from all liability, claims, demands, causes of action & possible causes of action whatsoever, arising out of or related to any loss, damage or injury (including death) that may be sustained by the undersigned's minor child while engaged in or en route to or from any of said activities from any cause, including the negligence of any of the parties released herein with the sole exception that this release does not apply to intentional or wanton misconduct causing injury or death.

  • 6. The undersigned is responsible to cover the cost of any damages caused by or a result of the conduct of their child.

  • 7. The undersigned acknowledges that Bigtime and Children’s Harbor are not to be held responsible for any items lost or stolen.

  • 8. The undersigned authorizes Bigtime to use pictures of our (my) child on Bigtime's website, publications, or social media.

  • 9. Consistent with CDC guidelines, participants are encouraged to practice good hygiene and social distancing to reduce the risks of exposure to COVID-19. Bigtime has put in place some preventative measures to reduce the spread of COVID-19. However, Bigtime cannot guarantee that its participants, volunteers, partners, or others in attendance will not become infected with COVID-19.

$9,999.99

Payment

Payment Method

  • Please make check payable to:
    Bigtime Ministries
    PO Box 43707
    Birmingham, AL 35243

Payment Summary



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