Children's Summer Extravaganza
Date: June 4, 2022
Time: Drop-off @10:00 a.m.; Pick-up @ 2:00 p.m.
Address: Gainesville Baptist Church, 3570 NW 16th Blvd, Gainesville, FL  32605
Contact: (352) 378-8358 or gainesvillebaptist@gmail.com
Sign in to Google to save your progress. Learn more
Parent's Name *
Email *
Phone Number *
Address *
Will you be staying with you child or dropping off your child? *
Required
Names and Ages of Children *
Who do we contact if you are not available and there is an emergency? (Name, Relationship, & Phone#) *
Comments
MINOR PERMISSION TO PARTICIPATE AND MEDICAL RELEASE.    I hereby grant permission for my child/children to participate in the above activity of the Gainesville Baptist Church. I understand that my child participates in these activities at their own risk and that the Gainesville Baptist Church and its adult supervisors are not liable for any injury personal or otherwise to my child or caused by my child. Should any problems arise concerning the behavior of my child that would require them to return home prior to the end of the activity, I will come pick up my child early.  I authorize the treatment, by a qualified and licensed medical doctor, of the minor(s) listed above in the event of any medical emergency which, in the opinion of the attending physician, is necessary and I/we cannot be reached after reasonable effort has been made to secure my personal consent.  I am responsible for any medical expenses. PHOTO / MEDIA RELEASE.   I recognize that the Gainesville Baptist Church uses photographs and video images of events in their publicity materials such as the church website, social media, brochures, and flyers, and I hereby grant permission for photo/video images of myself and/or my child to be taken and used for such purposes. (PARENT/GUARDIAN SIGN BELOW) *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy