Adventure Club Registration

Adventure Club registration

The RED asterisk indicates a REQUIRED field

What grade level is your child today?

Child's Address*


( )   -

( )   -

Who else can pick up your child?

What issues should we be aware of? If none, please enter "none"

Please Read and Acknowledge the Statements Below

By checking the boxes below, you acknowledge the statement.*

We (I) are the parent(s) or legal guadian(s) of the above mentioned child and hereby grant our/my permission for him/her to participate fully in the Student's Ministry of Rancho Baptist Church. In the event of an emergency, we hereby give our (my) permission to take said child to a doctor or medical facility, and hereby authorize medical treatment, including but not limited to emergency surgery. We (I) assume the responsibility of all medical bills, if any. I understand that Rancho Baptist Church will do its best to contact us (me) before any such treatment is administered.

By checking the boxes below, you acknowledge the statement.*

I give permission for my child to be photographed and/or videotaped for future promotional materials, yearbook and website postings. I do so without expectation of compensation and with the understanding that these photographs and video images will be used exclusively by RBC for its publications, website, and publicity purposes.