Clone of Adventure Week 2025 Participant Registration

Participant's Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Gender*

MaleFemale
Last Grade Completed (Registration is open to children Completed Kindergarten - Completed Grade 5. Children must be five years old on or before September 1, 2025.)*
Are there any allergies or medical concerns?*

NoYes, please describe:
Does your child have any special needs? (You may receive an email from Kids@Warren staff to further discuss, if necessary.)*

NoYes, please describe:
Would you like to register another participant?*

YesNo

Participant's Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Gender*

MaleFemale
Last Grade Completed (Registration is open to children Completed Kindergarten - Completed Grade 5. Children must be five years old on or before September 1, 2025.*
Are there any allergies or medical concerns?*

NoYes, please describe:
Does your child have any special needs? (You may receive an email from Kids@Warren staff to further discuss, if necessary.)*

NoYes, please describe:
Would you like to register another participant?*

YesNo

Participant's Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Gender*

MaleFemale
Last Grade Completed (Registration is open to children Completed Kindergarten - Completed Grade 5. Children must be five years old on or before September 1, 2025.*
Are there any allergies or medical concerns?*

NoYes, please describe:
Does your child have any special needs? (You may receive an email from Kids@Warren staff to further discuss, if necessary.)*

NoYes, please describe:
Would you like to register another participant?*

YesNo

Participant's Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Gender*

MaleFemale
Last Grade Completed (Registration is open to children Completed Kindergarten - Completed Grade 5. Children must be five years old on or before September 1, 2025.*
Are there any allergies or medical concerns?*

NoYes, please describe:
Does your child have any special needs? (You may receive an email from Kids@Warren staff to further discuss, if necessary.)*

NoYes, please describe:

Emergency/Authorized Pick-Up Information

*A matching Parent Security Badge will be required for pick-up. It is our policy to release children to adults and teens over 16 years of age.
# 1 Emergency Contact's Name (Please list someone other than yourself. This will only be used if you are unable to be reached.)*

First NameLast Name
Relationship*
Phone Number*
# 2 Emergency Contact's Name (Please list someone other than yourself. This will only be used if you are unable to be reached.)*

First NameLast Name
Relationship*
Phone Number

PHOTO RELEASE

*By registering your child for Adventure Week at Warren Belvedere, you give permission for your child to be photographed and/or videotaped for Warren Baptist Church/Warren Belvedere's promotional materials and social media. If, for any reason, your child's photo may not be used, you must email susans@warren.church with your child's name, grade, and a clear image of your child.
Terms and Conditions

I/We, the parents/guardians of the above-named child/ren, hereby give approval for my/our child/ren to participate in Adventure Week at Warren Belvedere. I/We assume all risk and hazards incidental to such participation. I/We hereby grant permission for any church staff or adult volunteer present to obtain necessary medical, dental, or mental health treatment in case of sickness or injury to my child/ren when I/we are not available and agree I/we shall be financially liable for said treatment and agree to indemnify and hold harmless Warren Baptist Church/Warren Belvedere, its staff, and adult volunteers for any such treatment. I/We do verify that the above information is correct and waive, release, absolve, infemnify, and agree to hold harmless Warren Baptist Church/Warren Belvedere's staff, volunteers, and chaperones from any claims, demands, and actions arising out of damage or injury to my/our child/ren while participating.
By marking "Yes", you are acknowledging you have read and agree with the above information regarding Emergency Contact/Authorized Pick-Up, Photo Release, and our Terms and Conditions.*

Yes
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Warren Belvedere Adventure Week 2026

This is a free event for all children who have completed Kindergarten through completed 5th grade.

Participant Information