Name *

First Name

Last Name

Phone (optional)

(###)

###

####

I give my permission for myself or those in my care to get rides to and from Cornerstone Church *

Yes

I understand that if the child or children in my care won't listen to Cornerstone leaders or respect the rules, they will not be allowed to continue to get rides and attend.

Yes

I release the Cornerstone drivers and leaders from any liability, and assume all responsibility for myself and/or those in my care during their time at Cornerstone Church. *

Yes