2021 Summer Bible Adventure Registration
Summer Bible Adventure July 12-16, 2021 9:30am-12:30pm
Child’s First Name *
Nickname if applicable.
Child’s Last Name *
Gender *
Child's Entering Grade *
AS OF FALL 2021
Does your child ever have bathroom accidents during the day? *
T-Shirt Size *
Parent #1Full Name *
Parent #1 Cell Phone Number *
Parent #1 Email *
Parent #2 Full Name
Parent #2 Phone Number
Parent #2 Email
First Emergency Contact Name and Relationship *
Other than Parents listed above
First Emergency Contact Phone Number *
Second Emergency Contact Name and Relationship
Other than Parents
Second Emergency Contact Phone Number
Does your child have any food allergies and/or dietary restrictions? If yes, please list trigger, reaction and if epipen is needed. *
Does your child have any non-food allergies? If yes, please list trigger, reaction and if epipen is needed. *
Special considerations/Anything else you would like SBA Caregivers to know about your child?
i.e. if your child has medical issues we should know about, is shy, has a friend attending SBA, has any special needs, etc. (anything additional we should know about your child that may help us work with him/her.)
Would you like to help SBA this year as an adult volunteer? *
Required
Photograph Permisssion *
During SBA, we would like to take images including still photos or live videos of children to display on bulletin boards, church bulletins, local newspapers, the parish website or social media. (no names, addresses or phone numbers would be included with information).
I, the parent, or legal guardian of the participant, do hereby grant permission for my child to participate fully in the St. John the Evangelist Church Summer Bible Adventure and all its activities. In the case of a medical emergency, I hereby give permission to St. John the Evangelist Church Summer Bible Adventure leaders, if I cannot be located in sufficient time at the above emergency number, to take said participant to a doctor or hospital and hereby authorize necessary medical treatment. I fully and completely assume responsibility for all medical bills. In consideration for the use of facilities owned or operated by St. John the Evangelist Church in Hopkinton, MA, the undersigned hereby releases and holds harmless St. John the Evangelist Church, its employees and volunteer workers from any and all claims for injuries and/or damage that may arise out of the use of such facilities by children of the undersigned. *
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