Intro

All quizzers participating in the South Central Regional 2019 (hereinafter referred to as The Event) MUST HAVE a liability waiver signed by their parent or legal guardian. No quizzer will be allowed to quiz with their team without a completed waiver on file. No paper waivers will be accepted on site at The Event.

Agree and Acknowledge

I understand and acknowledge that if I proceed to register online and to sign the waiver electronically, that, under the Electronic Transactions Act, such electronic registration and electronically signed Waiver document will be valid and enforced in the same manner as a hand-signed document that exists in physical form and that a record or signature may not be denied legal effect or enforceability under law solely because it is in electronic form.

Basic Information

Use parent or guardian information if under 18

Contact Information

Use parent or guardian information if under 18

Authorized on-site representative :
Minor Information

Enter the information for the children for which you are responsible for:



I, hereby authorize event personnel to obtain medical care or dental care, if necessary. My signature authorizes emergency treatment in the event of illness/injury when I am not immediately available. I understand, if necessary, the attendee will be taken to a nearby medical facility and will be attended by a physician on call. I further understand that I will be responsible for any medical expenses incurred. I also hereby authorize this document to be released to first responders and emergency personnel. Prior to the event, I will provide in writing any medications, allergies, and/ or special diets for the attendee to my local church Junior Bible Quiz Coordinator (or delegate) who will be attending the event. Furthermore, I agree that any/all media captured (photos, video, audio) is the property of the South Central Region Junior Bible Quiz and can used for future promotion.

Signature

By entering my name below and clicking the “Submit Waiver” button below, I indicate my acceptance and delivery of this waiver and release. I acknowledge that I have been given an opportunity to prevent or correct any error in connection with this waiver form. If I have submitted this waiver form in error, I will immediately notify you of the error, revoke my signature as instructed, and refrain from participating in any event or activity to which the waiver applies, as provided in Section 204(b) of the Uniform Electronic Transactions Act.