Adventure Club Registration

Parent's Name(s)

Parent's Email

Full Home Address

Parent's Phone Number and/or Emergency Contact Person

1st Child - First name and any food allergies

Birthdate

Age & Group

2nd Child - First name and any food allergies

Birthdate

Age & Group

3rd Child - First name and any food allergies

Birthdate

Age & Group

4th Child - First name and any food allergies

Birthdate

Age & Group

Do you have any special requests for your child? *Please note that we cannot guarantee to honor every special request, but we do take each request into consideration.

PARENTAL CONSENT AND RELEASE OF LIABILITY: I acknowledge that involvement of my Child/Children in the Galt Bible Church Adventure Club may involve risk of property damage and of personal injury, illness or even death, including but not limited to the risks arising from recreational activities, accidents in and around facilities, adverse weather conditions, and injuries and illness as a result of food-borne illnesses and allergic reactions. By agreeing to this Parental Consent and Release of Liability, I state that my Child/Children is/are fully capable of safely participating in all Adventure Club activities, and I expressly assume all risks of my Child/Children’s involvement, whether such risks are known or unknown to me at this time. I further generally release Galt Bible Church, their employees, volunteers, and other participants at Adventure Club, from any and all claims that I or my Child/Children may have against any of them, whether on or off Galt Bible Church grounds. This Release of Liability is given on behalf of myself, my Child/Children, and any heirs, family, estate, administrators, and personal representatives of me and my Child/Children.

CONSENT TO MEDICAL TREATMENT: I hereby give my consent that my Child/Children may receive medical treatment that may be deemed advisable in the event of injury, accident and/or illness during Adventure Club activities.

MEDIA RELEASE: I understand that by participating in Adventure Club activities, my Child/Children may be photographed. I agree to allow my Child/Children’s photo, video or film likeness to be used for any legitimate purpose by Galt Bible Church.

NO MOBILE DEVICE POLICY: At Adventure Club, we take the safety and innocence of the children in our care seriously. It is the policy of Adventure Club that children in attendance do not have unsupervised access to cell phones or devices while at Galt Bible Church for the purposes of participating in Adventure Club. We ask that if your child has a cell phone or other device, that it please be left at home or kept in your, the parent or guardian's, possession. In the event your child needs to get in touch with you, any of our leaders would be happy to allow your child usage of our cell phones or the phone in the church office for this purpose. By agreeing below, you are acknowledging your understanding of this policy, as well as your agreement to not send a cell phone or other device with your child to Adventure Club.

AUTHORITY TO SIGN/AGREE: I represent and warrant that I am a parent or legal guardian of the Child/Children named above and have the full power and authority to enter into this Parental Consent and Release of Liability on behalf of my Child/Children. By agreeing below, I acknowledge that I have read and understand this document, and also represent that all information provided is accurate.