Grace First Presbyterian Church LOGOS Program 2023-2024 Registration Form
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Family Adult/Guardian Full Name *
Phone Number *
Email Address *
Home Address *
City & Zip Code *
Participant's Name
Under your child's name, please list any allergies, including medications and food. Please list any medical or special needs, including medications currently being used.
Child's Full Name #1 *
Child's Age *
Grade entering for the 2023-2024 School Year *
Child #1 T-Shirt Size *
Child's Full Name #2
Child's Age
Grade entering for the 2023-2024 School Year
Clear selection
Child #2 T-Shirt Size
Child's Full Name #3
Child's Age
Grade entering for the 2023-2024 School Year
Clear selection
Child #3 T-Shirt Size
Doctors Name and Phone Number
If family adult/legal guardian is not available in an emergency, contact (name and phone number) *
Names and phone number of persons who may pick-up your child(ren) from LOGOS
I need assistance with transportation.  From where/when? To where/when?
I am willing to provide a carpool.  From where/when? To where/when?
I consent for Grace First Presbyterian Church to use photos and likeliness for:                                                External Church Publications (GFPC website and Facebook) Names will never be disclosed on external publications. *
Please read important disclaimer before proceeding
I understand my child(ren) will be treated with first aid in an emergency situation and authorize adult volunteers of Grace First Presbyterian Church as agent(s) for the undersigned, to consent to any medical or surgical care deemed advisable by any accredited physician or surgeon in an approved emergency clinic or hospital. I further release from any liability Grace First Presbyterian Church any of its ministries or leaders in the event of an accident in route, during and returning from the above mentioned event. This agreement does not apply to claims for intentional misconduct or gross negligence. *
Required
Electronic Signature *
Date Signed *
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