FBC Midweek Child Registration

FBC Midweek Child Registration

August 2026-May 2027
Parent/Guardian Information
Parent/Guardian #1

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Parent/Guardian #2

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contacts
Emergency Contact #1 Name

First NameLast Name
Emergency Contact #1 Relationship to Child
Emergency Contact #1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact #2 Name

First NameLast Name
Emergency Contact #2 Relationship to Child
Emergency Contact #2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please provide the following information about your child(ren):
Children's Information:
Terms & Conditions
Terms and Conditions
1. I consent to and approve my child(ren) taking part in any and all activities conducted by First Baptist Church Midweek. I understand that my child(ren) may participate in physical activities such as those held during game time. As with any physical activity, there is a risk of injury. I fully accept this risk and consent to the treatment of any minor injuries of my child(ren), and release, hold harmless, and indemnify First Baptist Church and their officers, directors, agents, employees, and volunteers from any and all liability, claims, and costs arising from or growing out of such treatment. In the event of an emergency that requires medical treatment for the above named child(ren), I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to First Baptist Church volunteers to secure the services of a licensed physician to provide the care necessary for my child's well being. I assume responsibility for all costs connected to any accidents or treatment of my child.

2. I understand that any off-property FBC Midweek excursions will be communicated with me beforehand and I will be required to sign a separate medical release form in order for my child to participate in those excursions.

I have read and agree to the Terms and Conditions stated above.
I give permission for photo(s) of my child(ren) to appear among other general ministry photos in any and all media as long as there is no identifying information published by First Baptist Church. I hereby wave any causes of action I may have because of the use of my child's photograph.
Parent/Guardian Name (this serves as your digital signature)
Date
Should be Empty:

FBC Midweek Child Registration

Parent/Guardian Information

Emergency Contacts

Please provide the following information about your child(ren):

Terms & Conditions