Therefore, since we have such a hope, we are very

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2016 Therefore, since we have such a hope, we are very bold. 2 Corinthians 3:12

Friday March 11th – Sunday March 13th Ø Drop off is 6:00PM on Fri, Pick up is 12:00PM on Sun, both @ Covenant Church. Ø Cost is $115. Checks made payable to Covenant with “BOLD 2016” on the memo line. Ø Bring: clothes, toiletries, sleeping bag, pillow, towel, sneakers, Bible, journal and pen. Ø Please eat dinner before you come on Fri. (Snack provided Friday night.) Ø Please detach bottom portion and hand in with payment. Ø Last day to sign up is Sunday Feb 28th Ø Please talk to Pete or Josh before handing in registration. (Detach here and return with your payment)

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COVENANT STUDENT PERMISSION FORM for BOLD 2016 I GIVE MY PERMISSION FOR MY CHILD TO ATTEND AND PARTICIPATE IN BOLD FROM MARCH 11- 13, 2016 (INCLUDING TRANSPORTATION). I HEREBY RELEASE AND HOLD HARMLESS COVENANT CHURCH, IT’S STAFF AND VOLUNTEER YOUTH WORKERS, FROM RESPONSIBILITY AND LIABILITY FOR ANY INJURY OR ILLNESS THAT MY CHILD MAY SUSTAIN DURING THIS EVENT. I AUTHORIZE AN ADULT LEADER, AS AN AGENT FOR ME, TO CONSENT TO AN X-RAY EXAMINATION; MEDICAL, DENTAL OR SURGICAL DIAGNOSIS; TREATMENT; AND HOSPITAL CARE ADVISED AND SUPERVISED BY A PHYSICIAN, SURGEON OR DENTIST (AS APPROPRIATE) LISCENSED TO PRACTICE UNDER LAWS OF THE STATE WHERE SERVICES ARE RENDERED, EITHER AT A DOCTOR’S OFFICE, ANY HOSPITAL, OR AT ANY CLINIC. I EXPECT TO BE CONTACTED AS SOON AS POSSIBLE. STUDENT’S NAME: ________________________________________________________________ DATE: ________________________ PARENT’S NAME: ___________________________________________ EMERGENCY PHONE #: _________________________________ PARENT EMAIL ADDRESS: ________________________________________________________________________________________ STUDENT EMAIL ADDRESS:________________________________________________________________________________________ HOME ADDRESS: _____________________________________________________________ STATE: _______ ZIP: _________________ PARENT/GUARDIAN SIGNATURE: ___________________________________________________________ DATE: ___________________ ALLERGIES: __________________________________________ MEDICATIONS: ______________________________________________