Brown’s Chapel Baptist Church
Wednesdays 6:00-7:30PM - Beginning September 7, 2022
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Child's Name *
Child's Current Grade/Age *
Address *
Phone Number *
Parent/Guardian First & Last Name *
Emergency Contact Name & Number/Relationship *
Church Home *
Food Allergies *
Any medical conditions/medications we should be aware of? *
I have read & understand the Covid-19 guidelines and procedures for TeamKid at  Brown's Chapel Baptist Church. *
By checking the box below, I hereby release, forever discharge and agree to hold harmless Brown's Chapel Baptist Church of Paragould, AR, its Pastors, Board Members, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the activities. *
By checking the box below, you are consenting to put your greatest treasure into our care, which is our honor and privilege. We will do everything we can to keep your child safe and sound as we participate in TeamKid. *
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