Student Registration Forms

(Please Print Off And Completely Fill Out The Information Below)

WAIVER OF LIABILITY STATEMENT

I, the parent or legal guardian of the minor listed below, release First Baptist Church, Hinesville, together with the adults in charge, from any and all claims resulting from injury or damage that may be sustained by my child while participating in or traveling during the activity listed below.

I/We consent to the use of any video images, photographs, audio recordings, or any other visual or audio reproduction that may be taken of the subject of this release to be used, distributed, or shown as First Baptist Church of Hinesville sees fit, including but not limited to publications or web sites.

(In reference to the preceding paragraph, please check below)

YES ____ NO ____

I/We understand all reasonable safety precautions will be taken at all times by First Baptist Church of Hinesville and its agents. I/We understand the possibility of unforeseen hazards and know the inherent possibility of risk. I/We agree not to hold First Baptist Church of Hinesville, its leaders, employees, and volunteer staff liable for damages, losses, disease, or injuries incurred by the subject of this release form.

 

 

Event: _____________________________________________________________ 

Date of Event: _______________________________________________________

Name of Participant: ___________________________________________________

Name of Parent: ______________________________________________________

Phone # (if different from participant’s): (______)_________________________________

Signature of Parent: ________________________________ Date: ___ / ___ / ___