Parent/Caregiver Information

Parent/Caregiver Name

Parent/Caregiver - Relationship To The Child(ren)

(For Texting Purposes Only)

(For Texting Purposes Only)

Spouse/Caregiver #2

Other Transportation

Home Information

Address Where The Child(ren) Resides

Other Than A Parent/Caregiver, Who Will Be Transporting The Child(Ren)?

Legal Release

I (we), by signing this release, do hereby agree to the following: In the event of an accident or injury occurring on the premises of Faith Baptist Church, to myself (ourselves) and/or anyone else under my (our) care, control, or custody, do hereby agree to hold Faith Baptist Church and its insurance company free and harmless and to present no claim for damages against Faith Baptist Church or its insurance company.

Name Of The Adult Authorizing The Legal Release And Approve Of Emergency Medical Treatment If Needed For