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Participant Registration

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Cedarbridge Baptist Church

Location

1111 Greenville Blvd SE

Greenville, NC 28590

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Contact Abbey Clayton:

252-916-8326

aclayton@cedarbridgechurch.com

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Country

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Contact Phone 1

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Contact Phone 2

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Text Message Phone

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup Phone

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This year we are including these required waivers below as a part of our registration process. Thank you for taking the time to read and sign them.

PHOTO & VIDEO RELEASE AND CONSENT FORM

I herby grant permission to Cedarbridge Baptist Church ((hereafter CBC)and its employees and volunteers to take photographs and/or videos of the minor child(ren) named in this registration.

I grant permission for Cedarbridge Baptist Church to use my child(ren)’s image, video, and voice recordings in videos and posts on social media sites and public websites including but not limited to Facebook, YouTube, and the CBC website.

I understand that my child(ren)’s name(s) will not be used in conjunction with any video or digital images.

I further acknowledge that I will not be compensated for these uses, and that CBC exclusively owns the rights to the images, videos, and recordings, and to any derivative works created from them.

This release is binding on me and the dependent(s) named in this registration, and I sign it voluntarily.

By signing (typing) your name below, you are acknowledging that you have read and agree to the "Photo & Video Release and Consent Form" above.

Signature

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If you did not sign the photo & video release above, please explain below.

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WAIVER OF LIABILITY

I/We, the undersigned, give permission for Cedarbridge Baptist Church’s (hereafter CBC) Children and Youth Ministry for my child(ren) to take part in any activity that is relevant to these ministries and VBS.

I, therefore, release CBC from any responsibility other than normal supervision and care. In case of accident, I will not hold Cedarbridge Baptist Church, its staff, or its volunteers liable. Further, I waive any claim or cause of action against the forgoing parties, which may arise as a result of an accident, illness, or injury to my child.

In the event of accident or injury, I authorize CBC staff or volunteers to provide first aid and to transport and secure medical treatment for my child.

I understand that I will be responsible for any and all costs related to medical treatment and/or hospitalization.

I understand that CBC, its staff, or its volunteers will not be held responsible for any articles lost, stolen, or left at the church.

I understand it is my responsibility to inform, both verbally and in writing, the appropriate event leader or staff member of any relevant information that affects the safety of my child, including health conditions, allergies, or custody arrangements.

Signature

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Grade Entering

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Gender

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Date Of Birth

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Shirt Size

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Allergies

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Medical Concerns

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