2023 Fallapalooza Registration
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Email *
Parent/Guardian Name *
Email *
Phone Number
Address (optional)
Name of Other Adult(s) in Group
I am a member of Calvary Baptist Church *
Required
Child #1 Name
Child #2 Name
Child #3 Name
Would you like to be contacted by a Pastor? *
Today's Date *
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TERMS AND CONDITIONS:                                                                            1. I hereby grant that all person(s)/children that are listed on this registration have my permission to participate in the Fallapalooza Event. I release, hold harmless, and forever discharge CBC, its members, agents, volunteers, and employees from all liability, action, damage, claim, or judgement for injury to the person or property of any/all persons listed on this registration, that may occur as a result of participation in this event-accrued or un-accrued, vested or contingent, known or unknown.  2. I give permission for a photo/video of all person(s)/children listed on this registration to appear in all public Calvary Baptist Church publications.                                                                                     BY TYPING MY NAME BELOW, I certify that I have read and agree to the Terms and Conditions stated above.  I understand this will act as a written signature.     *
Signature of Adult #2  BY TYPING MY NAME BELOW, I certify that I have read and agree to the Terms and Conditions stated above.  I understand this will act as a written signature.     *
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