Parent’s Night Out 2024 Nov 14, 2024 | Uncategorized Parent/Guardian First Name(Required) Parent/Guardian Last Name(Required) Email address(Required) Phone number where parent can be reached during event(Required) Second phone number where parent can be reached during event (optional) Children attending(Required)Please list the names, ages, allergies, and special needs for each child who will attend.Medical Release(Required)As their legal guardian, I hereby give permission for my child to attend and participate at Parent's Night Out sponsored by Hampton Baptist Church. I authorize an adult, in whose care the minor has been entrusted, to consent to any x-ray examination, anesthetic, medical, surgical, or dental diagnosis or treatment, and hospital care, to be rendered to the minor under the general and special supervision and on the advice of any physician or dentist licensed under the provisions of the applicable Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned youth pursuant to this authorization. The undersigned does also hereby give permission for my child to ride in any vehicle designated by the adult in whose care the minor has been entrusted while attending and participating in activities sponsored by Hampton Baptist Church. I agree to the medical release policy.
