• Summer Bible Club Registration 2022

  • CHILD INFORMATION:

    • 1stChild  

    • 2ndChild  
    • ADDITIONAL CHILD INFORMATION


    • 3rdChild  
    • ADDITIONAL CHILD INFORMATION


    • 4thChild  
    • ADDITIONAL CHILD INFORMATION

    • 5thChild  
    • ADDITIONAL CHILD INFORMATION

    • 6thChild  
    • ADDITIONAL CHILD INFORMATION


    • Stopper  
    • PARENT/GUARDIAN INFORMATION:

    •  -
    •  -
    •  -
    • MEDICAL INFORMATION:

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    • I release all photos taken at Grace Baptist Church. I understand that they may be used in official marketing or for club illustrations.

    • Waiver/Release:

      I, the undersigned parent/guardian, do hereby grant permission for my son/daughter, named above, to be accepted for all activities to be held by Grace Baptist Church during Summer Bible Club June 27-30, 2021. We (I) do hereby release, forever discharge and agree to hold harmless Grace Baptist Church at 5050 Middlebranch Avenue NE of Canton, Ohio; its pastors and volunteer staff from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child participant that occur while said child is participating in the above described activities.  Furthermore, we (I) hereby assume all risk of personal injury, sickness, death, damage and expense as a result of our (my) child(ren)'s participation in all activities involved therein.

      We (I) are/am the parent(s) or legal guardian(s) of this/these participant(s), and hereby grant permission for him/her/them to participate fully and hereby give permission to its pastors and volunteer staff involved to take said participant(s) to a doctor or hospital for authorized emergency treatment, including but not in limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any.  I also understand that every attempt will be made to notify us (me) or the emergency person listed below in such an emergency.  Furthermore, should it be necessary for the participant(s) to return home due to medical reasons, disciplinary action or otherwise, we (I) assume all costs involved.

    • Should be Empty:
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