Merge - Fall 2022 Registration Form
Merge is our mid-week discipleship program for students in grades 4,5 and 6. This fall we will be doing a program called "Grow" to help us grow deeper in relationship with Jesus. This is intended for students who want to dig in and do the homework required and commit to attending all 8 weeks of the program. 
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What is your child's name? (first and last) *
Parent/Guardian name (first and last) *
Parent/guardian phone for emergency contact *
Will you attend on Wednesday night at Connors Hill or Thursday night at Southeast? *

I hereby consent to the participation of my/our child(ren) in this supervised activity at Central Baptist Church.

While every precaution is taken for the safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at Central Baptist Church. I/we understand and accept these risks and agree that by allowing my child to participate in those activities, they may be taking part in a recreational activity that presents the potential for personal injury.

I/we, named below, undertake and agree to indemnify and hold blameless Central Baptist Church, its Personnel, its Directors and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Central Baptist Church. This consent and authorization is effective only when participating in events of Central Baptist Church.

I have read, understood and agree with above.

If so, please type your name in the space below to indicate your consent for your child to participate in Merge for Fall 2022.

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