• FBG Kids Permission and Waiver Form

    August 1, 2026-August 15, 2027
  • Child's date of birth:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • The following OTC medications (or generic equivalent) are available from a chaperone. Please indicate if you give permission for your student to take these medicines ‘as needed’ by checking yes or no. Only medicines that are checked ‘yes’ and determined to be necessary will be administered at the discretion of the chaperone/staff. Administration of these medicines will be per label instructions unless otherwise indicated by your physician.

  • Tylenol (or generic equivalent) for discomfort/fever:*
  • Advil (or generic equivalent) for discomfort/fever:*
  • Throat lozenges for throat irritation and/or cough:*
  • Benadryl, oral (or generic equivalent) for allergies:*
  • Cortizone cream, topical (or generic equivalent) for allergies:*
  • Visine drops (or generic equivalent) for eye irritation:*
  • Imodium (or generic equivalent) for diarrhea:*
  • Pepto (or generic equivalent) for upset stomach:*
  • Tums (or generic equivalent) for heartburn and/or upset stomach:*
  • Insurance information: type in requested information - OR - upload front and back of medical insurance card

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  • MEDICAL HISTORY, SPECIAL MEDICAL NEEDS OR CONCERNS, MEDICATIONS, ALLERGIES, DIETARY NEEDS, CONDITIONS AND/OR OTHER INFORMATION THAT LEADERS SHOULD KNOW ABOUT YOUR CHILD SHOULD BE LISTED ON REALM REGISTRATION PER INDIVIDUAL EVENT.

  • Functions and Activities

    It is my understanding that participating in the programs and recreational and other activities of First Baptist Greenville (FBG) is a privilege. Prior to my child's participation in such activities, I acknowledge that there are certain risks associated with the activities including, by way of example, physical injury due to activity related accidents, physical injury due to transportation related accidents, illness, or even death. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware. I am being asked to execute this document with legal significance with I understand is intended to affect legal rights which I, my spouse, or a legal representative, could possibly have againg FBG, the ministers, the staff, or church members which arise out of, or relate to, my participation in this activity. By signing below, I am agreeing, individually, and on the behalf of any other person who might claim a right as follows:

    Release of Liability

    By signing this Permission/Waiver Form, I expressly warrant that the child named above is capable of withstanding the physical demands of the activities discussed above. I further release and agree to hold harmless, defend and indemnify FBG and its directors, officers, employees, leaders and agents from and against any and all claims for personal injury (including loss of life) and all other losses or damages, except those caused entirely by the gross negligence or intentional conduct of FBG arising from my or my child's participation in its activities and programs. I waive any claim for injury, disability, disease, death or property damage which results from my participation in the church sponsored activity described in this waiver. This release specifically covers and releases any and all claims against FBG, its ministers, staff, and church members for their own negligence.

    First Aid and Emergency Medical Treatment

    I recognize that there may be occasions where the youth named above may be in need of first aid or medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of FBG to seek and secure any medical attention or treatment for the child named above, including hospitalization, if in the agent’s opinion such need arises. In doing so, I agree to pay all fees and costs arising from this action to obtain medical treatment. I give permission for attending physicians(s) and other medical personnel to administer any needed medical treatment, including surgery and, again, I agree to pay for the medical treatment.

    Special Events and Field Trips

    I understand that the child named above will be participating in various activities from August 1, 2026 through August 15, 2027. I understand that during this period my child may take part in activities such as: Fall Retreat, Denver Downs, Worship Arts Camp, Missions Week, Camp Prism and other activities consistent with the purposes of the church.  I also understand that I may be asked to sign Special Permission Slips in addition to this form.

    Publicity

    On occasion, FBG takes photographs or makes an audio or video tape recording of children and/or adults involved in church activities. Such photographs or video records may be used by staff and participants to remember the activities or participants. In addition, such photographs and audio/visual recordings may be used in FBG publications or advertising materials to let others know about our ministry. In addition, local news organizations may hear of our activities or events, and our church may invite or allow them to photograph or record our events for news reporting on special interest features. I consent to the use of any such audio or visual record of the child named above to be used, distributed, or displayed as agents of the church see fit. This consent includes but is not limited to: photographs, videotape, and audio recordings. Furthermore, I give permission for the child to be interviewed by the news media, or for such photographs and other audio or visual records to be used by the news media.

  • Parent/Guardian Authorization

    I represent that I am the parent/guardian of the above child who is under 18 years of age. I have read the above Permission/Waiver Form and am fully familiar with the contents thereof.

    I give permission for the youth named above to participate in the activities of FBG, including any special events/activities described above. In consideration for allowing the participation of the child in the activities of FBG, I hereby consent to the Permission/Waiver Form, including the Release of Liability above, on behalf of the youth, and agree that this Permission/Waiver Form shall be binding upon me, my family, heirs, legal representatives, successors, and assigns.

    I also understand that it is my responsibility to see that the information on this form is updated when there are any changes in my child’s medical status, etc.

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