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About
What We Believe
Who We Are
Core Values
Our Team
Ministries
Sunday Mornings
Children’s Ministries
ALBC Youth Crew
Young Adults
ALBC – Worship Team
Missions & Outreach
Women
Small Groups
Night Church
Events
Messages
Audio
Videos
Blog
Contact
Home
The Great Spring Break Adventure – Registration
The Great Spring Break Adventure – Registration
Monday, March 27th
– Friday, March 31st, 2023
Spring Break Registration:
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 (ALBC) 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 (ALBC) Children’s Ministry is a privilege. I hereby give permission for my son or daughter, indicated in this form above, to participate and engage in the activities of (ALBC) Children’s Ministry.
- I further release (ALBC) and its’ employees, adult Children’s Ministry leaders and volunteers from any and all liability claims arising from my son’s 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 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 (ALBC) or it’s 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.
Consent
*
Permission to Use Images and Video
I hereby grant permission for Abundant Life Baptist Church to record sounds, images, or video of my child (named above) while attending this Day Camp program.
I also give permission for Abundant Life Baptist Church at its sole discretion, to use these sounds, images or videos in publications (including print, websites, and social media platforms) owned by Abundant Life Baptist Church in relation to this Day Camp program.
- 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.