Summer Evening Kid’s Club 2022 – Registration

A Look at Jesus’ Kingdom Parables

Registration:

Summer Evening Kid's Club - Registration 2022

Sunday, August 7th - Friday Aug 12th *Required

1 Intro

2 Contact Information

3 Parental Consent and Liability Release

Email*
Childs Name*
Address*
Date of Birth*
Date Format: MM slash DD slash YYYY
Age*
Grade*
Sex*
- Male
- Female
Personal Health ID (9 digit)*
Personal Health ID (6 digit)*
Family Physician - Name and Contact Number*
Allergies or Medical Conditions*
Any medications, dietary needs, restrictions:*

Parent's/Guardians Names*
Phone Numbers*
Emergency Contact Name*
Relationship*
Phone Numbers*
I permit the use of video and photography of my child for the promotion of (ALBC)*
- Yes
- No

Consent*
I agree to the terms and conditions
In the event that my son/daughter requires special medical treatment during his/her participation in this event and its activities, including transportation to and from the activity, I the parent/guardian will be notified immediately.

If all reasonable attempts to contact me have been unsuccessful, I hereby consent and give my permission to the physician(s) and any other medical personnel selected by the adult Children’s Ministry leaders or volunteers of Abundant Life Baptist Church to hospitalize, secure proper medical treatment for, and/or to order x-ray examination, injection, anesthetic, surgery or dental diagnosis and obtain medical information deemed necessary for my child as named above which may in their discretion be necessary.

I hereby warrant that to the best of my knowledge, my son/daughter is in good health and I assume all responsibility for the health of my child. I agree to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned Child pursuant to this authorization.

It is my understanding that participating in the programs and activities of the Abundant Life Baptist Children’s Ministry is a privilege. I hereby give permission for my son or daughter indicated above to participate and engage in the activities of Abundant Life Baptist Children’s Ministry.

I further release Abundant Life Baptist and its’ employees, adult Children’s Ministry leaders and volunteers from any and all liability claims arising from my son or daughter’s participation in its activities and programs, or as a result of accident, injury, illness or wrongful death caused by negligence or any other cause of my son or daughter during such activities.

I permit the use of video and photography of my child for the promotion of Abundant Life Baptist Church.

I have disclosed in writing all physical, allergic, dietary and behavioral needs of my child.

I consent to the collection and use of my personal information as specified by the Personal Information and Electronics Act, for any purpose needed by The Abundant Life Baptist Church or its designates.

I represent that I am the parent and/or guardian of the Child named above, who is under 18 years of age. I fully understand the consequences of and sign this Parental Consent & Liability Release form knowingly, freely and willingly.