Clone of 2024 Snow tube Registration

Event Details

Come join the Youth Ministry on a winter adventure to remember as we hit the slopes of Liberty Mountain Resort in Carrol Valley Pennsylvania for a day of snow tubing on Saturday January 31, 2026. Everyone ages 6 and above is welcome. Children under 12 years old must be accompanied by a parent or guardian. The cost is only $50 per person and includes transportation and your 2-hour snow-tubing lift ticket. Please bring money for food. The bus will leave sharply at 8:30 am and return at 4:00pm. Permission information will be required with this registration for children 17 and under. Register online by Sunday, January 11, 2026. For more information email Minister Ryan Richardson .

Name*

First NameLast Name

Phone Number*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

E-mail*

example@example.com

How many children would you like to register?*

Child1 Name*

First NameLast Name

Child2 Name*

First NameLast Name

Child3 Name*

First NameLast Name

Child4 Name*

First NameLast Name

Child5 Name*

First NameLast Name

Total cost for children

How many adults would you like to register?*

Adult1 Name*

First NameLast Name

Adult2 Name*

First NameLast Name

Adult3 Name*

First NameLast Name

Adult4 Name*

First NameLast Name

Adult5 Name*

First NameLast Name

Total cost for Adults

PLEASE CHOOSE THE NUMBER OF ADULTS AND/OR CHILDREN YOU WANT TO REGISTER!

Parent/Legal Guardian Name*

First NameLast Name

Parent/Legal Guardian Name

First NameLast Name

Activity Information

My child has permission to participate in the Youth Ministry outing being held on Saturday, January 31, 2026. I am aware that my child can be transported to Liberty Mountain Resort 78 Country Club Trail, Carroll Valley, PA 17230 on, January 31th at 8:30 a.m. The bus will return to the church on at 4:00 p.m. The activity will not be chaperoned by the Kettering Baptist Church Children Ministry Staff. In the event that my child requires medical attention, the Youth Director or adult chaperone may act as an agent in my absence. I am providing our health coverage information, so that prompt medical treatment may be obtained, and accept responsibility for all necessary medical expense(s). In case of an accident, I do not hold Kettering Baptist Church, its staff, or the adult chaperones responsible. Kettering Baptist Church does not carry accident insurance for group activities. I may be contacted at the following phone number(s) in case of an emergency:

I may be contacted at the following number(s) in case of an emergency.
1)   Area Code*   Phone Number*   ,2)_Area Code   Phone Number  or 3)___   Area Code   Phone Number  .
Our family medical coverage is provided by    Provider*   .
The ID Number is ID Number*      and Group Number is    Group Number  .
(Please insure you or your child has a copy of their insurance card with them.)

List Allergies*

Required Medication*

I understand that Kettering Baptist Church, the Youth Director, adult chaperones, nor the event staff is liable in the event of an accident or injury to my child. I also assume full responsibility for the consequences of my child’s actions during these activities and agree to come for him/her, if contacted to do so. I shall be responsible for meeting my child PROMPTLY at the designated time and place of return.

The person(s) authorized for removal of my child(ren) is/are:

Name*

First NameLast Name

Drivers License Number*

Name

First NameLast Name

Drivers License Number

Parent/Legal Guardian’s Name Printed*

Parent/Legal Guardian’s Signature*

2026 Snow Tubing*

USDTotal Amount due for Snow Tubing

Total registrants*

Calculation

Snow Tubing Registration/Permission Form