FBKids and FBYouth Registration

FBKids and FBYouth Registration
I give permission: For my child/children to attend Wednesday night First Baptist Church (FBC) events. I give FBC permission to seek medical attention for the child/children listed below if necessary. I here by voluntarily release, discharge, waive and relinquish any and all loss or damage or actions or causes of action for personal injury, property damage or wrongful death occurring to my child(ren) during his or her involvement with FBC activities.
I give permission: For any photos taken during FBC activities to be used for publicity.
I give permission: For My child to be transported in FBC vehicles.

I Have Read and Acknowledge our Waiver of Liability and Hold Harmless Agreement*
If my child(ren) needs to be removed from an activity for health, safety, disciplinary issues, I will pick them up promptly.

*All FBKids and FBYouth forms are available on our website www.fremontfbc.org under the "Youth" tab.
Child Name

First NameLast Name
Nick Name
Gender
Birth Day
Grade
School
Child Name

First NameLast Name
Nick Name
Gender
Birth Day
Grade
School
Child Name

First NameLast Name
Nick Name
Gender
Birth Day
Grade
School
Parent/Guardian

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Parent/Guardian

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
Emergency Contact Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
My Child(ren) will need weekly transportation to and from FBC.
Any Medical Conditions or Allergies we should be aware of:
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Date

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Date
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