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Parent's Night Out Registration 
Friday November 13th from 6:00-8:30pm for kids 6 weeks to 5th grade only. Please make sure that all of the children who are attending are listed on this form
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Parent/Guardian Name *
Email *
Phone Number *
Alternate Phone Number (Spouse's Phone) *
Child 1 Name *
Child 1 Age *
Child 2 Name
Child 2 Age
Child 3 Name
Child 3 Age
Child 4 Name
Child 4 Age
Child 5 Name
Child 5 Age
Child 6 Name
Child 6 Age
I, the parent or legal guardian of the student listed on this form, certify that he/she has my full approval to participate in this McDonough Christian Church Program.  The child identified on this form understands that all students are expected to abide by the Program rules and be directly responsible to the MCC Staff. MCC Staff assumes responsibility for discipline at the Program and, if necessary, may because of misconduct or disobedience, require a student to leave.  In such instance, I will assume full responsibility for returning the student home at my expense. Further, I do release and hereby agree to hold blameless MCC and its Staff from any and every claim arising, or which may be asserted by me or by any member of my family by reason of participation in any activities associated with MCC Programs.                                                                                                      *COVID RELEASE*                          
Under Georgia Law, there is no liability for an injury or death of an individual entering these premises if such injury or death results from the inherent risks of contracting covid-19.  You are assuming this risk by participation in this event.                                                                                   *MEDIA / PHOTOS*                         
I understand the photos will be used for informational, promotional, and instructional purposes only and will not be used to generate a profit or for any other commercial purposes.  I have not been compensated nor will I seek compensation for the photos.  I release McDonough Christian Church from responsibility should a third party violate the terms of this release.   I authorize MCC to photograph my family (including minors), and any work or actions performed by them during and for church sponsored events.                                                              *DISCLAIMER*                               
In the case of a medical need or emergency I authorize McDonough Christian Church to allow medical treatment for my child.  This includes performance of first aid, administration of medicine, use of medical transportation, hospitalization, etc.  This authorization lasts from January 1, 2026 through December 31, 2026 and applies to any activity in which my child participates that is sponsored by MCC.  I understand that it is my responsibility to inform MCC, in writing, if my child will be affected by an allergy, medication, or medical condition while he or she participates in any activity sponsored by MCC.  I also understand that it is my responsibility to inform MCC, in writing, if any address, phone number or insurance information on this form changes.  I also allow that a signed photocopy of this form is valid if the original is unavailable. Further, I do certify that said child is covered by adequate accident insurance.  My consent and signature is given below.   I have read and agree to the information given in this entire form.
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