JUBILEE CHRISTIAN SCHOOL

Basketball Release Form

2009

I fully acknowledge that my child ________________________________, will be

participating in the JCS Basketball Program. In granting this permission, I understand
that I bear full legal and financial responsibility for my child. I release Jubilee Christian
School and Mount Lebanon United Presbyterian Church and any of its representatives
from any and all claims and causes of action for loss of property and personal injury
sustained by my child in the course of this activity. I verify that my child has coverage
under an adequate medical insurance plan.

Parent’s Signature: ________________________________ Date: _______________

JUBILEE CHRISTIAN SCHOOL

Basketball Release Form
2009

I fully acknowledge that my child ________________________________, will be

participating in the JCS Basketball Program. In granting this permission, I understand
that I bear full legal and financial responsibility for my child. I release Jubilee Christian
School and Mount Lebanon United Presbyterian Church and any of its representatives
from any and all claims and causes of action for loss of property and personal injury
sustained by my child in the course of this activity. I verify that my child has coverage
under an adequate medical insurance plan.

Parent’s Signature: ________________________________ Date: _______________