Christmas Toy Drive!

Child's First Name

Child's Last Name

Age of Child

Child's Gender

Name of Guardian/Parent

Email of Guardian/Parent

Phone Number of Guardian/Parent

Schedule Pick-Up Time

Consent To Use Photographs

I give my consent.

I do not give my consent.

I grant participating parties in charge of this event and its representatives and employees the right to take photographs of my child while being serviced and at the event. I agree that they may use such photographs of my child with or without my name (permission) for any lawful purpose.

Event Terms and Conditions

I have read and understood the below.

By signing this form I hereby release and hold harmless Healing a Broken Heart Foundation and Revealed Truth, their directors, staff, officers, employees, volunteers, and park staff (after this “Releases”) from any liability, claims, demands, actions, and causes of action whatsoever arising out of any related to any loss, damage, injury, including death, that I may have sustained, or any property belonging to me, whether caused by the negligence of the Releases, my own action(s), or otherwise.