Love, Joy, Peace...


Name (Required)
Age
Grade
Parent Name (Guardian) (Required)
Phone Number (Required)
We will call this number in case of emergency
Address
Email Address
Is your child allergic to anything?
If yes, what are they allergic too?
Does your child have any special needs?
If yes, please describe so that we can best meet your child's needs.
By filling out this form, as the parent/guardian, I understand that reasonable precautions will be taken to safeguard the health and well-being of this child during any church event, and that I will be notified as soon as possible in the event of an emergency. In case of sickness or an accident, I authorize and consent to Fort Bayou Family Church, or other associated volunteers to obtain medical care from a licensed medical professional, hospital, or medical clinic for the child described above, if myself or other legal guardians cannot be reached. I do hereby release and forever discharge Fort Bayou Family Church, and other associated volunteers from all manners of actions, claims, which I or the child shall or may have for any reason, arising during the child’s attendance during church functions, on or off of the church premises. Unless other written instruction is submitted, I also consent to allowing the child’s image to be recorded, either by photograph or video for publicity.