2022 Registration Form
Summer Bible Adventure July 11-15, 2022  9am-12pm, $100/child (with a $250 family max)
Scholarship available on payment link where necessary.
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Email *
Child’s First Name *
Nickname if applicable.
Child’s Last Name *
Gender *
Child's Entering Grade *
AS OF FALL 2022
Does your child ever have bathroom accidents during the day? *
T-Shirt Size *
Parent #1 Full Name *
Parent #1 Cell Phone Number *
Parent #1 Email *
Parent #2 Full Name
Parent #2 Cell 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. *
Please select one option below *
If your child has some sports activity restrictions at SBA, please explain below:
Special considerations/anything else you would like us to know about your child? (Special medical conditions, shy, friend attending SBA, etc?)
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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A copy of your responses will be emailed to the address you provided.
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