Register Canvas & Clay and THRIVE Wednesday Nights Child's Name* First Last Child's Gender* Male Female Child's Age*Current Grade in School* 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade Parent/Guardian Name(s)*Address Street Address City State / Province / Region Phone*Email Home ChurchAllergies, Medical Conditions, Special Needs. (If none, write NONE)*In Case of Emergency, Contact:*Emergency Contact Phone Number*Emergency Contact's Relationship to Child*WE CANNOT GUARANTEE SOCIAL DISTANCING DURING OUR WEDNESDAY NIGHT ACTIVITIES. BY CHECKING THE BOX BELOW YOU ARE ACKNOWLEDGING THAT: I agree to assume and accept full responsibility for the inherent risks of COVID-19 and those inherent risks not specifically identified. My child's participation in Canvas & Clay and THRIVE is purely voluntary, and I elect to allow my child to participate, in spite of and, with full knowledge of the inherent risks.* I agree to the safety consent regarding COVID-19BY CHECKING THE BOX BELOW YOU ARE ACKNOWLEDGING THAT: I agree that First Baptist Church has the right, but not the obligation to use my child's photograph, likeness (including caricature), for the website or Facebook page, at any time and for any other purpose of materials the ministry deems necessary. Your child's name will not be used.* I give permission for my child to be photographed at any church function. I DO NOT give permission for my child to be photographed at any church function. BY CHECKING THE BOX BELOW YOU ARE ACKNOWLEDGING THAT: I understand that transportation will be provided by FBC, New London on their church van.* I give permission for my child to ride the church van to attend Canvas & Clay and THRIVE.
