RCBC KIDS CREW REGISTRATION FORM

RCBC Registration Form

Please fill the form below and let us know if you give go ahead for this child's participation
- Participant Name
  
  First NameLast Name
- Age
- Date of Birth
  
  MonthDayYear
- Phone Number
  
  Area CodePhone Number
- Grade
- Medical Problems/ Allergies
- Parent's Name
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
- E-mail
  example@example.com
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Emergency Contact Name
  
  First NameLast Name
- Emergency Contact Phone Number
  
  Area CodePhone Number
- CONSENT FOR MEDICAL TREATMENT | In the event of an illness or injury involving my child while participating at ROCKWOOD COMMUNITY BAPTIST CHURCH, I authorize the church staff and volunteers to provide reasonable first aid and care for my child during children's church activities such as cleaning wounds, applying bandages, using ice packs, and providing basic first aid as needed.
  
  I also authorize ROCKWOOD COMMUNITY BAPTIST CHURCH to contact 911 and seek emergency medical treatment for my child.
  
  I understand that every reasonable effort will be made to contact me or my designated emergency contact as soon as possible.
- Signature
- LIABILITY RELEASE AND WAIVER | I understand that participation in children's activities, programs, classes, and events at ROCKWOOD COMMUNITY BAPTIST CHURCH may involve normal risks associated with activities involving children, including BUT NOT LIMITED TO play, crafts, games, physical activities, and other interaction with other participants. I voluntarily allow my child to participate and acknowledge that reasonable care will be provided by church staff and volunteers.
- Signature
- CONSENT FOR PHOTO RELEASE | As the parent or legal guardian of the above-named participant, I hereby grant permission for ROCKWOOD COMMUNITY BAPTIST CHURCH to photograph and/or record my child during children's church activities and events. I understand that these photos and videos may be used by the church for ministry purposes, including church presentations, newsletters, printed materials, the church website, and social media, to share and promote the ministries of the church. I understand that no compensation will be provided for the use of these recordings or images. By signing below, I acknowledge that I have read and understand this release and grant permission for my child's image and/or likeness to be used as described above.
- Signature
- By signing and submitting this registraiton form, you understand and agree to all policies.
- Parent/Guardian Signature
  
  First NameLast Name
- Today's Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Comments and/or Questions:
- Should be Empty:

RCBC Registration Form