CTU: REVERB

Parent/Legal Guardian Name:

Parent/Legal Guardian Cell Phone:

Name of Teen Attending: (Please fill out this form for each individual teen in your family!)

Cost:

I give my teen(s) permission to take part in the trip to Hershey, PA for Word of Life REVERB on November 7-8, 2025. I am the legal guardian of the teen(s) and hereby grant my permission for him/her/them to participate fully in the said event and release them (Word of life: REVERB) and Calvary Baptist Church, the pastors, directors, and volunteers from all liability relating to the event and activities therein. In case of a medical emergency, I understand that every effort will be made to contact a parent or guardian of the teen(s). In the event I cannot be reached, I hereby give permission to the physician selected by Calvary Baptist Leadership to hospitalize and secure proper treatment for an injection or anesthesia or surgery for my teen(s) named above. Further, should it become necessary for the teen(s) to return home due to medical reasons, disciplinary actions or otherwise, I assume the full responsibility. *BY CHECKING THE BOX YOU ARE SIGNING AND AGREEING TO THIS WAIVER.

Yes, I agree

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

11/7-11/8

What: All-night event packed with a life-changing message, intense games, eye-popping prizes, incredible activities and great food until early in the morning!

*NEW THIS YEAR*
Trampoline Park!!!!

When: Friday 4:30pm, November 7 through Saturday, 9:30am, November 8

Where: Starting at the Giant Center: 550 Hersheypark Drive, Hershey, PA 17033
Continuing around Hershey ALL NIGHT

Cost:

Early Bird Tickets ($65) end on October 10th.

Standard Tickets ($75) end on October 29th.

After November 3rd, At the Door Ticket cost ($85)

50% off Tickets are available to help students reach their unsaved friends.

Check out the Reverb website just for students at wol.is/reverbstudents. Students can send the link to friends when inviting them to Reverb.

CTU: REVERB

Description

Please Fix the Following