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2017-18 AWANA Information and Permission Form

  • Heritage Baptist Church
    2017 – 2018 Information and Permission Form

    I hereby give permission for my child to participate in all indoor and outdoor activities including the playground on the property of Heritage Baptist Church. I give permission for Heritage Baptist Church to treat minor abrasions while my child is in its care. I agree that if I or my emergency contact person cannot be reached by the church in the case of illness or accident requiring a physician’s immediate attention, my child’s physician may be called and is authorized to treat my child. If the named physician cannot be reached, I give permission for a physician designated by Heritage Baptist Church to administer treatment at my expense.

    By completing this form, I show that I understand and accept the policies and the above permission given as an agreement with Heritage Baptist Church and release the church from liability for injury or illness resulting under all circumstances save gross negligence.

  • Other person or relative to be contacted in event of an emergency:

  • Please complete the following information regarding your health insurance coverage:

  • This field is for validation purposes and should be left unchanged.
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