Event Title:
GINGERBREAD HOUSE CONTEST
Event Date:
12/6/2019 to 12/6/2019
Event Time:
6:00 PM
Event Location
Living Hope Baptist Church
Event Fee:
$0.00
* Required Information
Parent/Guardian Information
* First Name:
* Last Name:
*Address:
* City:
* State:
PA -- Pennsylvania
Please select
** -- **Blank**
AK -- Alaska
AL -- Alabama
AR -- Arkansas
AZ -- Arizona
CA -- California
CO -- Colorado
CT -- Connecticut
DC -- District of Columbia
DE -- Delaware
FL -- Florida
GA -- Georgia
GU -- Guam
HI -- Hawaii
IA -- Iowa
ID -- Idaho
IL -- Illinois
IN -- Indiana
KS -- Kansas
KY -- Kentucky
LA -- Louisiana
MA -- Massachusetts
MD -- Maryland
ME -- Maine
MI -- Michigan
MN -- Minnesota
MO -- Missouri
MS -- Mississippi
MT -- Montana
NC -- North Carolina
ND -- North Dakota
NE -- Nebraska
NH -- New Hampshire
NJ -- New Jersey
NM -- New Mexico
NV -- Nevada
NY -- New York
OH -- Ohio
OK -- Oklahoma
OR -- Oregon
PA -- Pennsylvania
PR -- Puerto Rico
RI -- Rhode Island
SC -- South Carolina
SD -- South Dakota
TN -- Tennessee
TX -- Texas
UT -- Utah
VA -- Virginia
VI -- Virgin Islands
VT -- Vermont
WA -- Washington
WI -- Wisconsin
WV -- West Virginia
WY -- Wyoming
* Zip:
* Phone:
Secondary Phone:
* E-Mail:
Church Affiliation:
How did you hear about this event/activity?
Emergency Contact Information
(This information is only needed if you will not be staying on the premises during the event)
Contact Name:
Relationship to Child:
Contact Phone:
* Child 1 Information
Name
Gender:
Male
Female
Age:
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Grade Entering:
Pre-School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Food Allergies
Medical Needs:
Characters Left
Child 2 Information
Name
Gender:
Male
Female
Age:
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Grade Entering:
Pre-School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Food Allergies
Medical Needs:
Characters Left
Child 3 Information
Name
Gender:
Male
Female
Age:
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Grade Entering:
Pre-School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Food Allergies
Medical Needs:
Characters Left
Child 4 Information
Name
Gender:
Male
Female
Age:
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Grade Entering:
Pre-School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Food Allergies
Medical Needs:
Characters Left
Child 5 Information
Name
Gender:
Male
Female
Age:
4
5
6
7
8
9
10
11
12
13
Grade Entering:
Pre-School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Food Allergies
Medical Needs:
Characters Left
*
CHILDREN'S EVENT/ACTIVITY MEDICAL RELEASE FORM
I (We), the parent(s) or guardian(s) of the above listed child grant permission for our child to participate in the above listed activity / event to be held at Living Hope Baptist Church and to receive medical treatment if necessary. If I (we) or the listed emergency contact(s) cannot be reached, I (we) give our permission to the staff of Living Hope Baptist Church to secure the services of a licensed physician to provide the necessary care for my child's well-being. I (we) also agree to release and agree to hold harmless Living Hope Baptist Church and all its participants from any liability and assume all risk of injury, damage or expenses as the result of participation in the activities of this event / activity.
NOTE: Parent/Guardian signature will be required upon bringing your child to this activity / event.
Parent/Guardian Signature: _____________________________ Date: ________________________
*
CHILDREN'S EVENT/ACTIVITY PHOTOGRAPHIC RELEASE FORM
I (We) understand that as an attendee of this children's event / activity my child(ren) may be photographed during their participation. I also understand that these photographs may be used in presentation and promotional materials (of this event), and may be posted on Living Hope Baptist Church's website.
Yes
No
- I give Living Hope Baptist Church permission to use my child's photos of participation in this activity/event. I release Living Hope Baptist Church of any and all liability
NOTE: Parent/Guardian signature will be required upon bringing your child to this activity / event.
Parent/Guardian Signature: _____________________________ Date: ________________________
*
Verification Check:
Type the characters that you see in this picture.
When finished please click the Submit button.