2024 ABCCR Annual Gathering Child Registration Form

 

September 26, 2024 - Ministers Council Meeting and Dinner

September 27-28, 2024 

 

First Baptist Church, 803 S. Dinsmore Ave, Lyons, KS 67554

Celebration Centre, 1145 E. US #56, Lyons, KS 67554

 

Please complete a separate registration form for each person

Childcare for children ages 3-10 is being offered on Saturday morning ONLY beginning at 8:00 AM until approximately 11:30 AM. Childcare is $5 per child.

Consent for Emergency Medical Care for a Minor: By signing this form, I hereby authorize the Kansas Baptist Convention, Inc. also known as the American Baptist Churches of the Central Region and First Baptist Church of Lyons, Ks to consent to any medical care and treatment for my child that is recommended by a licensed healthcare provider to whom the Child is presented for treatment. In order to ensure that the Child receives prompt medical care and treatment when necessary, I hereby release any licensed health care provider providing medical care to the Child in reliance of this form from liability relating to such provider's acceptance of my substitute care giver's consent. If you consent, sign your name below:

Consent for Media Release of a Minor:

I, the undersigned individual, grant American Baptist Churches of the Central Region (ABCCR located at 5889 SW 29th St, Topeka, Kansas, and First Baptist Church of Lyons, KS the perpetual, non-exclusive, royalty-free right and license to: Record my participation and appearance on digital or film photography, video, audio or any other medium. Use my name (or any fictional name), likeness, voice and biographical material and information in connection with these recordings to be used only in or for ABCCR written, electronic and web publications, including social media and apps to be used for the promotional material, multimedia and publication purposes of the American Baptist Churches of the Central Region.+ Reproduce, distribute, publicly display and/or publicly perform, in print, electronic or any other medium, copies of the recordings, in whole orin part. Grantor represents that he or she possesses all rights necessary to grant this permission for and in connection. I am voluntarily making this grant of rights. I further agree to release and forever discharge ABCCR, its agents, employees and designated representatives from any and all claims in law or equity that I, my heirs or personal representatives have or shall have arising out of recordings. Consent I am the parent or guardian ofthe minor named above and have the legal authority to execute the above release. I approve and waive any rights in this release. If you consent, sign your name below: