2020 Pacer Faith & Family Night
Sign-Up by December 13!
Check-in begins at 5:15 PM January 2, 2020 at Crossroad Community Church. Van(s) will leave CCC at 5:30 sharp. If you are not at CCC by 5:30PM it will be your responsibility to get transportation to Bankers Life Fieldhouse.
Cost is $20.00 Per person. Please include payment with registration form. Cost includes your ticket to the game, a Chick-Fil-A meal voucher, a Pacers hat, and a post game acoustic performance by Tenth Avenue North!
We will be at Bankers Life Fieldhouse until 10:30 and will return to CCC at 11:00PM.
- In case of emergency call Warren Robison at (317) 401-1044
- Possession of tobacco, drugs, alcohol, or behavior that is harmful to the group or facility will result in immediate parent pick up and loss of fee.
- Please dress appropriately.
- Please do not bring valuables that you cannot be responsible for. CCC staff and volunteers will NOT be responsible for replacing lost phones, iPods, etc.
Please cut off the entry form and return it with your check. Keep the above info for reference. Make checks payable to Crossroad Community Church
I give permission for my son or daughter __________________________________________________, to participate in the Crossroad Community Church Pacer Faith and Family Night event on January 2, 2020. In the event of an emergency where medical treatment is required, I give permission to the Crossroad Community Church staff or volunteer to obtain the services of a licensed physician. Please attempt to notify me immediately. During this activity, I can be reached at:
Home Phone: (____) ______-____________ Cell Phone (____) _____-___________
Signed_____________________________________________________ Date: _________________________
(Parent or guardian)
Printed: ___________________________________________________ Relationship _____________________
In consideration of the minor’s participation in the CCC event, I (we) agree to release, indemnify and hold harmless Crossroad Community Church, its employees and agents, contracted or otherwise, from any liability, diseases, or damages resulting from said participation.
Student Name: _____________________________________________________________________________