J.E.W.E.L.S. ANNUAL KICKOFF BRUNCH

Participant's Name

First NameLast Name

Grade

Select Grade Level, Adult Registrant, or Volunteer

Gender

This Field is Require

Participant's Phone Number

Format: (000) 000-0000.

Participant's Email

Legal Parent/Guardian Authorizing Participation

Parent/Guardian's Phone Number

Format: (000) 000-0000.

Parent/Guardian's Email

Emergency Contact Name & Phone No.

I, as an adult participant or the parent/legal guardian of the minor listed, hereby release and hold harmless Foster Chapel Baptist Church, its partners, and its volunteers from any claims of personal injury that may occur during participation in VBS activities.

In the event of an emergency, I consent to emergency medical treatment for myself or the minor participant listed while in the care of the Foster Chapel Baptist Church VBS ministry leads.

I authorize the Foster Chapel Baptist Church VBS ministry and its agents to take and use photos or videos of myself or the minor child listed above.

List Allergies

Type NA if None

Additional Comments

By submitting this registration form, I acknowledge that I am the parent or legal guardian of the child listed and that my submission serves as my electronic signature.

"GOD'S DREAM TEAM"