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Summer Adventure 2021 on Monday, June 21, 2021 @ 8:45 AM

Please note that 'Attendee' is the name and information of the child attending.  The parents information will be gathered further down on the form.  
Remember to register your children into the grade that they will be entering FALL of 2021, not the grade they are currently in. 
For families registering 4 or more siblings, please contact our Grace Kids office at 661-296-8737 x154 and you will be given a discount promotional code. :
Child Info/Special Needs (Asthma, allergies, physical limitations, custody concerns, etc.:
*Date of Birth:
A friend your child would like to be with:
Another friend your child would like to be with:
*Shirt Size:
Will parent be volunteering? If so, where?:
*Parent/Guardian Name:
*Parent/Guardian Primary Phone Number:
Parent/Guardian Secondary Phone Number:
*Alternate Contact Name:
*Alternate Contact Relationship:
*Alternate Contact Phone Number:
Additional Individual(s) authorized to pick up child:
*What church does the family regularly attend?:
*Photo Release:
Waiver Acknowledgment ASSUMPTION OF THE RISK AND WAIVER OF LIABILITY RELATING TO CORONAVIRUS/COVID-19 - The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited or limited the congregation of groups of people. - Grace Baptist Church has put in place preventative measures to reduce the spread of COVID-19; however, the Church cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the Church or Church-related activities could increase your risk and your child(ren)'s risk of contracting COVID-19. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -:
By affirming this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the Church or Church-related activities and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Church or Church-related activities may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Church employees, volunteers, and Church-related activity participants and their families. - I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)'s attendance at the Church or participation in Church-related activities ("Claims"). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Church, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Church, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Church-related activity. :
I understand and agree that the law of the State of California will apply to this Waiver of Liability. Please sign your initials that you acknowledge and agree to this Waiver of Liability, and that you are aware that as of now, children ages 3 and up will be required to wear a mask. :
*Parent's Initials: