Electronic Signature Acknowledgement: By typing your name in the Parent/Guardian Signature box, you are signing the document electronically. You agree that your electronic signature has the same legal validity and effect as your handwritten signature on the document, and that it has the same meaning as your handwritten signature. You may also elect to print the document, sign it by hand and submit it personally.

I (the parent/guardian of registered student under 18 years of age) have been informed of and understand that he/she will be voluntarily be participating in the Bread of Life High School Winter Retreat from February 13 until February 16, 2026 which is being sponsored by the Bread of Life Church (Ling Liang Worldwide Evangelistic Mission). I am aware of the information set forth above and I consent to my child’s participation in the activity described. I understand that if I have any questions, I may contact the coordinator of this camp for further information. In return for my child’s participation in the above activity, I agree that my child and I, or assignees, heirs, and legal representatives will not make any claim against the Bread of Life Church, its affiliated organization, its employees, and membership, any counselor, coordinator or person directing or participating in the activity. I also hereby release the Bread of Life Church, its affiliated organization, its employees, and membership, any counselor, coordinator or person directing or participating in the retreat from all claims that my child and I, our assignees, heirs, and legal representatives may hereafter have for injury or damage resulting from my child’s participation in the activities above. I have carefully read the information printed above and understand its meaning and content.

Electronic Signature Acknowledgement: By typing your name in the Parent/Guardian Signature box, you are signing the document electronically. You agree that your electronic signature has the same legal validity and effect as your handwritten signature on the document, and that it has the same meaning as your handwritten signature. You may also elect to print the document, sign it by hand and submit it personally.

I agree that in the event that I cannot be reached in an emergency, I hereby give the Bread of Life Church personnel permission during this activity to use their judgment in obtaining medical service for the child and I give permission to a physician selected by the coordinator or other person directing the activity to hospitalize, secure treatment for, and/ or give injections, anesthesia, or surgery for my child. I understand that the Bread of Life Church carries only liability coinsurance. This means that if my child becomes injured or ill on this church sponsored activity, my own family medical insurance will be billed first. If I have no insurance of if my insurance doesn’t cover all necessary medical costs, Bread of Life Church’s policy will make up the difference.