FRBC Vacation Station Summer Camp 2023
If you have multiple children, you may fill out 1 form, but please add necessary information for each child.
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Registration/ Permission & Release Form for Summer Camp
Child's Name
Child's date of birth
Child's grade for the next school year (2022-2023)
Parent/ Guardian Name
What is the best way to contact you?
e-mail or phone/text 
(Make sure to provide the email or phone #)
Person to call if parent/ Guardian can not be reached:
Emergency Contact Name/ phone#
Does your child know how to swim?
Clear selection
Are there any special health conditions that FRBC should know about? 
(such as allergies, seizures, heart conditions, etc)
As the parent (or guardian) of the above named attendee, do you grant permission for your son or daughter to attend Franklin Road Baptist Church’s 2023 activities and events and authorize Franklin Road Baptist Church and its chaperons, to transport and supervise your child in connection with his or her attendance at the various activities throughout the 2023 year?
Clear selection
Do you agree to the following release statement for FRBC activities?
I do hereby give, release, absolve, indemnify, and agree to hold harmless, Franklin Road Baptist Church, its staff, Deacons, Trustees, volunteers, and persons transporting my son/daughter to and from the activity and associated activities from any claim arising out of injury to my son or daughter, except to the extent such harm is the result of the intentional misconduct of Franklin Road Baptist Church or such other party seeking to enforce this release. 
Clear selection
Do you agree to the following medical care authorization for FRBC events?
As the parent (or guardian) of the above named attendee of Franklin Road Baptist Church’s children's activities, I hereby authorize Franklin Road Baptist Church and its chaperones to seek and have emergency medical first aid administered to the above named attendee during the 2023 year. 
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Do you agree to the following waiver for publicity?
 I give permission for the use of any photos, movies, and audio or video tapings of my child’s activities in connection with Franklin Road Baptist Church’s Children’s ministry, to be used with approval for educational or religious purposes, media coverage, or for publicity benefiting educational or religious purposes. 
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Will you be able to provide transportation to camp each day for your child?
June 7-9  9:30 am to 2:30 pm
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Is there any other information we need to know about your child?
Submit
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