KIDS AND TEENS ENROLLMENT FORM

I give permission for routine medical treatment to be administered to my child. In case of an emergency and I cannot be reached, I give the staff permission to secure the necessary emergency medical treatment for my child. I hereby expressly waiver any and all liabilities, damages, actions, or causes of action on the part of Bethel Baptist Church, East for any such injury unless is a direct result of the gross negligence or intentional acts of the staff. In addition, I understand and agree that Bethel Baptist Church, East is authorized to make audio and/or video recordings of the program activities, and I give permission for CDC to record this child’s picture and voice on photographs, films, and tapes, without payment, and to incorporate these recordings into public relations and advertising materials and to use in any manner of media whatsoever.

BETHEL EAST KIDS AND TEENS PROGRAM ENROLLMENT

BETHEL EAST
KIDS AND TEENS PROGRAM
ENROLLMENT