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Event Registration

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BA: Kids Day Registration - Volunteers on Monday, August 3, 2020 @ 9:00 AM

Requirements for Adult Volunteers 18 & up: You must register and have a current BattleCreek Church Adult Background Check on file or be willing to complete one. 

Requirements for Students 17 & under: You must register and have a onetime BattleCreek Church Minor Consent Form on file or be willing to have a parent/guardian complete one.  

All required forms will be sent to emails on file!

Please fill out the additional registration information below! *One Volunteer per registration.
*Volunteer First Name:
*Volunteer Last Name:
*Date of Birth:
*Which Campus do you attend:
*Adult or Minor Volunteer:
*If Student, Grade Completed:
*Primary Phone Number for all Communications:
*Primary Email for all Communications:
*Parent/Legal Guardian First Name for 17 & under *N/A for all others:
*Parent/Legal Guardian Last Name:
*Parent/Legal Guardian Cell Number for 17 & under *N/A for all others:
*Parent/Legal Guardian Email Address for 17 & under *N/A for all others:
*Emergency Contact First & Last Name *Must be Different than what is listed for Parent/Guardian :
*Emergency Contact Phone Number:
*Emergency Contact Relationship:
*Please list any Allergies *If none, list N/A:
*Please list any medical conditions that we need to be aware of *If none, list N/A:

Medical Release: 
By signing my name in the box below, I agree that I am the parent or guardian of the participant listed above, or am the participant myself, and am over the age of 18, and agree to the following conditions: I give my consent to BattleCreek Church, including any medical personnel, staff or volunteers participating in Kids Day, to administer to the participant any medical treatment, including medication, they deem necessary during the participant's participation at Kids Day. I further authorize BattleCreek Church staff and volunteers to obtain for the participant any outside or off-site medical and/or surgical treatment they deem necessary and authorize the treating physician (chosen by BattleCreek Church) and his or her medical staff to carry out any medical and/or surgical treatment in accordance with the treating physician's diagnosis. I understand that I will be notified, as soon as practicable, of any medical treatment administered to the participant and will be responsible for all costs associated with any such medical treatment. I also give BattleCreek staff and volunteers permission to transport the participant to obtain medical treatment or in the event of an emergency. I hereby agree to hold BattleCreek Church, including its representatives, agents, employees and volunteers, free of any and all liability, actions, causes of actions, claims, expenses and damages on account of injury to the participant or property; even injury resulting in death, which may arise in connection with the participant's participation in Kids Day or any other associated activities, including the administration of medical treatment.

*Medical Release First & Last Name Signature
*Insurance Company Name:
*Insurance Company Phone:
*Insurance Group Number:
*Insurance ID Number:
*Policy Holder First & Last Name:
*Policy Holder's Employer:
Photo/Video Release: By signing my name in the box below, I agree that I am over the age of 18 and am legally able to give consent for the aforementioned participant. I understand and will allow photos and videos of the participant taken while at Kids Day to be used in any of BattleCreek Church’s publications. I also understand that the publication of these photographs may be accomplished electronically via the Internet and that after publication BattleCreek Church will be unable to prevent persons from gaining access to the Internet, copying my photographs and video, and subsequently using, altering, or republishing it without my consent. I waive any claim for damages against BattleCreek Church from unauthorized use, alteration, or republication of photographs and video by third parties accessing the Internet.

*Photo/Video First & Last Name Signature