Youth Waiver & Release

FBC Student Ministries is open every Sunday morning at 9:15am and every Wednesday night from 6:30-7:30 (Drop off starts at 6:15 pm). Every week we have programmed curriculum, to help the students dive in the Word. Contact Will Wiley willwiley@fbcsenoia.org with any questions.
PARENT / GUARDIAN INFORMATION
 
 
 
 
 
EMERGENCY CONTACT (Other than Parent)
 
 
STUDENT'S INFORMATION
 
 
Please select one option.
 
 
 
 
 
 
 
 
 
 
AUTHORIZATION OF EMERGENCY MEDICAL TREATMENT
I hold harmless the First Baptist Church of Senoia and its representatives from any adverse reaction or results to the participant as a result of participation in events, activities or trips. I understand that in the event the participant requires medical treatment while engaged in events, activities, and trips with the First Baptist Church of Senoia, reasonable effort will be made to contact me. If I cannot be reached, then at the discretion of the ministry representative, I grant permission to the ministry representative acting on behalf of the ministry as agent for me, to obtain all necessary medical attention in case of sickness or injury. I realize that the release form is valid for use during the calendar year of January 1, 2026 - September 30th, 2026.  
Please select all that apply.
PERMISSION FOR PHOTOS & VIDEO
Does First Baptist Church of Senoia have permission to use photos/videos from the events for ministry development?
Please select one option.
E-Signature

I confirm that all of the information I provided is accurate in regard to myself.  By providing my electronic signature below, I agree that it has the same legal effect as a handwritten signature and constitutes consent to all terms of this document.

 

Description

FBC Student Ministries is open every Sunday morning at 9:15am and every Wednesday night from 6:30-7:30 (Drop off starts at 6:15 pm). Every week we have programmed curriculum, to help the students dive in the Word. Contact Will Wiley willwiley@fbcsenoia.org with any questions.