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Visitor release

indicates a required answer

Please complete this form before your requested visit. Submitting this form does not guarantee approval. Visitors may not attend Uplift activities until approval has been granted.  All visitors once approved when on campus must wear a name tag.
1. *

Full Name
2. *

Phone Number
3. *

Email Address
4. *

Date and time requested
5. *

Reason of visit
6. *

Will anyone be accompanying you?  Please list all who will be coming.
7. *

I understand that Uplift is a closed-membership organization and is not open to the general public.
Yes
8. *

I agree to follow all Uplift and church building access, check-in, supervision, and safety procedures.
Yes No
9. *

I agree to check in upon arrival, provide identification if requested under Uplifts procedures, and wear any required visitor identification.
Yes No
10. *

I will respect student privacy and will not photograph, record, or share information about students without appropriate authorization.
Yes No
11. *

I certify that the information provided on this form is accurate and complete. I understand that access to Uplift is a privilege requiring advance approval.
By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.
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