Sports_Craft2023

Registration Sports/Craft

* Indicates required field

Choose the activity to participate *

Name of Minor *

First

Last

Date of Birth *

Relationship *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Emergency Contact Information *

First

Last

Phone Number *

Family Physician Name *

Physician Phone *

Special medical allergies, chronic illness, or other conditions or services need: *

Date of last tetanus shot: mo/yr *

Does the child have a EpiPen? *

Yes No

Do you give Abram Creek Permission to administer the use of the EpiPen if medically necessary? *

Yes No

Next closest relative or designated person to contact *

First

Last

Closest Relative or Designated Person Phone *

We encourage parents/guardians to stay for the duration of the evening. By submitting the above information, in the event of an emergency, I give permission to administer medical care.

On the day of arrival please inform registration that you have completed the registration online. A participation agreement form will be pre-filled for the child and will require a signature of the parent/guardian, date and phone if not electronically signed.

I acknowledge that participation in the activity described above involves risk to the participant (and to the participant's parent/guardians, if the participant is a minor) and may result in various types of injury including, but not limited to the following: sickness, bodily injury, death, emotional injury, personal injury, property damage, and financial damage.

In consideration for the opportunity to participate in the activity described above, the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with the participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activities or during transportation to and from the activities as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, or any other representative (collectively referred to as the "activity sponsor"). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise. I hereby agree by submitting this form that I wish to electronically sign the participation agreement.

Submit

Registration Sports/Craft

Service Times

Abram Creek Baptist Church