Medical Release Form 2025
Dripping Spring Baptist Church asks for you to fill out a hard copy of the 2025 medical and photography release form, however, if you are unable to do so, we will accept the filling out of this form. By filling out this form, you agree that you have reviewed the hard copy of the form and agree to all terms mentioned in it. Additionally, we need some information about your student. 
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Student's Name  *
Birthday of Student  *
Gender of Student 
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Parent/Guardian Name *
Parent/Guardian Contact Number *
Secondary Emergency Contact if Parent/Guardian is unavailable (Name and phone number please).
Do you have Health Insurance that covers this student?
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Insurance Carrier and Group Number
Do you agree to allow your student to be photographed/video-graphed at DSBC related events and posted on our social media platforms, as mentioned in the hard copy of the waiver you received?  *
Have you read and agreed to the waiver, release, and indemnification agreement on the waiver you were provided? *
By signing your name, you agree to allow your student to participate in the events at Dripping Spring Baptist Church. Parent/Guardian Signature (Must be over 18 to type your name).  *
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