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To register, please fill out the information below. If you are registering more than one child you will need to fill out a form for each individual child.




represent that if the participant is a minor, I am his/her parent/guardian and authorized to provide the releases,

authorizations, and permissions stated below and all of the above is accurate and complete. I hereby give permission

for the person named above to participate in New Beginnings Christian Church activities (NBCC). I acknowledge that NBCC

has a policy for conduct in such programs and facilities and I hereby agree that the participant is subject to said policies,

including disciplinary provisions. I acknowledge that there are risks associated with NBCC activities and hereby agree

to release NBCC, its officers, employees, and volunteers, from all liability arising from and harm or injury incurred by the

participation of my child in the program stated above. By way of this form, I authorize the staff of NBCC to obtain

medical/hospital treatment for the above participant in the event of an emergency. NBCC or its staff are not responsible

for lost or stolen items. Electronic devises are not recommended and will be taken by staff and secured in a locked room.

Photographs, slides, and video footage of participants for use in publications, may be taken while participating in the

program activities. I hereby give NBCC permission to utilize photographs, slides, and video footage of the participant

for the purpose of promoting and publicizing NBCC programs and events, (including but not limited to their appearance

in brochures, NBCC’s website, photographs, and videotapes). No personal information other than the participant’s first

name will be released under any circumstances, except as required by law.

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