Glendale Release

Glendale Release Form

To whom it may concern:

I acknowledge and give my full consent for my child, ___________, a student at Legacy Christian Academy (LCA), to stay after school as part of Glendale at Cave Mill youth program. I understand and release LCA from all liability when my child attends Glendale’s youth ministry. This release form shall be in effect, unless notified of a change by the parent, for the academic year that runs from August 1, 2023 through May 31, 2024. Further, I give consent and authorize the leadership of Glendale at Cave Mill to provide or secure emergency health care for my child in the event of an accident or illness.

Preferred Contact #:

Child's Legal Name:

Mother's Signature:

Father's Signature:

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