NXTGEN Summer Send-Off Registration Form

Summer Send-Off Registration Form
Youth Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Grade Level
Parent/Guardian Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Acknowledgment
Waiver & agreement

Risk: I understand that water activities carry real risks — slips, falls, heat exposure, and other unforeseen injuries — and I voluntarily accept those risks for myself / my child.

Liability: I release Fairfield Baptist Church, its pastors, leaders, staff, and volunteers from any claims, liability, or causes of action arising from this event, including injuries caused by negligence.

Medical: In an emergency, I authorize FBC staff or volunteers to seek medical treatment for me / my child and accept responsibility for any costs incurred.

Sun & hydration: I agree to ensure sunscreen is applied and that me / my child stays hydrated throughout the event.

Behavior: I agree that all participants will follow NXTGEN leader and volunteer instructions. Failure to do so may result in removal from activities.

Guardian: If signing for a minor, I certify I am the legal parent or guardian with authority to sign on their behalf.
Allergies, medical conditions, or special instructions (leave blank if none)...
I have read and agree to all terms of this waiver on behalf of myself or the minor named in this registration.
Signature
Should be Empty:

Summer Send-Off Registration Form

Parent/Guardian Information

Acknowledgment