D-Now Registration

D-Now Registration

DNOW Registration Form Preview
D-Now Registration
  • D-Now Registration

  • Medical Details and Release

    For use in a Emergencies
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  • In case of an emergency, who should we contact?

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  • By completing this form, you agree to one of the following terms and conditions:

    1)

    I, the parent/legal guardian of the participant listed, a minor, whose date of birth is listed above, state that I am the parent/ legal guardian of the above-referenced child, of the address listed.

    I hereby give my consent for the above-referenced child to attend activities, events or functions sponsored by the Tishomingo County Baptist Association. I do hereby release, discharge, indemnify and hold the above-listed church, the Tishomingo County Baptist Association, and/or any of its members harmless from any and all actions, causes of actions, claims, and demands for, upon, or by reason of any damage, loss, or injury, which may be hereafter be sustained by the minor child arising out of any event while attending said activities, events, or functions.

    In case of an emergency wherein said minor child is required to seek major medical attention, I understand that all efforts will be made to contact me. However, in case I am unable to be reached, I direct that any adult may secure whatever medical care is necessary. In case of a minor injury, I agree that said minor child may be treated by the medical personnel on hand as necessary. In case of injury, the emergency contact listed on this form will be contacted.

    or

    2)

    I understand when I, a consenting adult, attend activities, events or functions sponsored by the Tishomingo County Baptist Association I do hereby release, discharge, indemnify and hold the above-listed church, the Tishomingo County Baptist Association, and/or any of its members harmless from any and all actions, causes of actions, claims, and demands for, upon, or by reason of any damage, loss, or injury, which may be hereafter be sustained by me, arising out of any event while attending said activities, events, or functions.

    In case of an emergency wherein I am required to seek major medical attention, I understand that all efforts will be made to contact the emergency contact listed above. However, in case he/she is unable to be reached, I direct that any adult may secure whatever medical care is necessary. In case of a minor injury, I agree that said I may be treated by the medical personnel on hand as necessary.

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  • By completing this form, e-signing and pressing submit, you enter a legal agreement with the Tishomingo County Baptist Association on the terms listed above.

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