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Beach Week Registration
Registration will be open until June 1st, the cost for this event is $250/student, and can be paid in person via cash or check to FBC Jefferson. Please contact Ben at bhall@fbcjefferson.org with any further questions.
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Student Name
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Student Grade
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Student DOB
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Student Gender
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Student T-Shirt Size
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Parent/Guardian Name(s)
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Parent/Guardian Phone Number(s)
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Parent/Guardian E-Mail(s)
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Allergies/Medical Concerns to be aware of:
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Emergency Contact Information (name, relationship, phone)
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Do we have your permission to post photos and/or videos to our student ministry social media accounts that may include your student?
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I hereby grant permission to the staff member in charge of the event to obtain necessary medical attention in case of sickness or injury for my student. I also agree to release and hold harmless the church and its staff from all liability related to injury or illness that may occur to my child in relation to this event or any activity associated with it. I do hereby further accept financial and physical responsibility for the return of our my student(s), should the adult supervision find it necessary to send them home.
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