Emergency Contact Information
If in an emergency, the parent(s) / guardian(s) cannot be reached, please notify:
Please read the following before agreeing to the statement:
This registration is complete and accurate. I know of no reason(s), other than indicated on this form, why my child should not participate in activities except as noted. I authorize the staff of Refton Church to seek and consent to medical treatment for my child, when either I or my assignee cannot be contacted. I understand that all necessary precautions will be taken for my child's safety and every effort will be made to contact me before such action is taken. I will not hold the church, its staff, or those supervising liable. I am aware that by selecting "I Agree", I am giving my full consent.