strength to stand sign-up

Student's Name *
Student's Name
Parent's Name *
Parent's Name
Phone *
Phone
Best Way To Reach You
Address *
Address
Medical Information
Date of Birth *
Date of Birth
Emergency Phone Number *
Emergency Phone Number
Permission of Treatment
I do hereby grant permission to the First Baptist Church of Parsons, TN staff and other adults in charge to obtain necessary medical attention in case of sickness or injury to my child. *
Release Statement
I do hereby verify that the above information is correct, and I do hereby release and forever discharge all sponsors and the First Baptist Church of Parsons, TN from any claims, demands, actions or causes of action, past present or future arousing out of any damage or injury while participating in a church-sponsored youth activity. *