First Baptist Church, Tucker, GA: Home: Parent's Night Out Registration Form


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Parent's Night Out Registration Form Participation in Parent's Night Out gives First Baptist Church of Tucker permission to use images and/or video footage of your child participating in the event for media purposes (e.g. screens, print (bulletin, Tiding newsletter), website, promotional materials, etc.). I also give my permission to First Baptist Church of Tucker to have my child medically treated in any emergency situation. I also release First Baptist Church of Tucker from any liability in connection with my child's participation in the activities of First Baptist Church of Tucker. * Required Errors First Name * Last Name * Email Address * Home Phone * ( ) - ext. Mobile Phone * ( ) - ext. Name and age (s) of individual(s) attending * Any Allergies * Emergecy Contact Person * Emergency Phone * Emergency Relationship * Physician Name, Phone & Hospital Preference * Medication * The following are authorized to pick up my child: * First Baptist Church of Tucker has my permission to use photos of my child/children at Valentine's Parent's Night Out for media purposes (e.g. web site, Sunday morning slide show, etc.) YES_______ NO_______ * How did you hear about Valentine's Parent's Night Out?
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