First Baptist Church of Columbia
Friday, May 18, 2012
 

Class Name:
 

Name: 

Street Address:

Apt # 

City:

State: 

Zip:

Home Phone:

Work Phone:

Date of Birth:

 M:     D:    Y:  

Email Address: 

Marital Status:
 

FBC Member: 

 Yes  No
Member of another church? Yes  No
 
 
 
Wavier of Participation:
By agreeing to this registration form, I assume all risk associated with participation in this activity including, but not limited to falls, contact with other participants, the effects of weather, equipment, condition of facilities, and all such risks being known and appreciated by me. Having read this wavier and knowing these facts, I, myself, and anyone who act on my behalf, waive and release the First Baptist Church of Columbia and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participating or my child (children) in this activity even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I have read and understand the above waiver of participation. In addition, my acceptance of this waiver signifies my permission that any photographs taken while participating in activities at the EFLC will become property of First Baptist Church and may be used in published materials.
 
I Accept