Kids Bible Camp

June 18-21, 2018 6:00pm - 8:00pm

PERMISSION AND LIABILITY RELEASE

As the parent or legal guardian, I give permission for the child(ren) under my care to participate in the KIDS CAMP hosted by First Baptist Church.  I do hereby release, forever discharge and agree to hold harmless First Baptist Church, its directors, employees, and agents thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature, whatsoever which may be incurred by the undersigned.

On this date: June 18-21, 2018

I hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein.

The undersigned further hereby agrees to hold harmless and indemnify First Baptist Church, its directors, employees, and agents, for any liability sustained by said church as the result of negligent, willful, or intentional acts of said participant, including expenses incurred attendant thereto.

Furthermore, I authorize treatment by a licensed Physician in case of an emergency which could endanger my child's life, or cause disfigurement, physical impairment, or undue discomfort if delayed.  I hereby authorize medical treatment, including but not in limitation to emergency surgery or medical treatment, and assume all responsibility of all medical bills, if any.

Finally, I give permission for my child's picture to be taken and used in the promotion & advertisement of church events & activities.

  • Parent/Guardian Name
  • Phone
  • Email
  • Street Address
  • City
  • State
  • Zip
  • Child
  • Grade
    K-2nd
    3rd-6th
  • Medical or other information we may need
  • K-2nd
    3rd-6th
  • K-2nd
    3rd-6th
  • K-2nd
    3rd-6th
  • K-2nd
    3rd-6th
  • Are you part of a church?
    Yes
    No
  • If yes, which church?
  • In the event of an emergency, whom do we call?
  • Phone Number