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Event Registration & Release Form

We’d love to get to know you! Whether you’re new to County Line Baptist Church, have a prayer request, or want to get involved, our Connect Card is the perfect way to reach out. Let us know how we can pray for you, serve you, or help you find your place in our church family.

Event Date
Month
Day
Year

Participant Information

Birthday
Month
Day
Year
Multi-line address

Emergency Contact Information

Medical Information

Parental/Guardian Consent (For Minors)

I, the undersigned parent/legal guardian of (participant's name), give permission for my child to participate in this event. I understand that reasonable safety precautions will be taken, but in case of an emergency, I authorize the event leaders to seek necessary medical treatment for my child.

Date
Month
Day
Year

Release of Liability

I, (participant’s name or parent/guardian if under 18), understand that participation in this event is voluntary. I hereby release County Line Baptist Church, its staff, volunteers, and representatives from any liability, claims, demands, or costs related to any injuries, accidents, or illnesses that may occur during the event.

Date
Month
Day
Year

Photo/Video Release (Optional)

I grant County Line Baptist Church permission to use photographs and/or video recordings of me (or my child) for church-related promotional materials, including social media and website use.

Multi choice
Date
Month
Day
Year
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