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Adult Release and Waiver of Liability

Minor Release and Waiver of Liability

Form

Form

Church Use Request

First Name

Last Name

Email

Name of Event

Date of Event

Start Time

End Time

Size of Group expected

Additional details (rooms needed, if rehearsal is needed, sound, etc)

Do you agree to have all participants fill out the appropriate release and waiver of liability? * Required

Yes

No

Not Applicable

Thanks for submitting!

Requests &
Forms

China

regional

church of the

nazarene

207-445-4838

chinaregnaz@gmail.com

Physical Address: 898 Rte#3 South China, ME 04358

Mailing Address: PO Box 530 So. China, ME 04358

©2020 China Regional Church of the Nazarene

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