SUMMER SLAM 2015 REGISTRATION
 
Youth's Information         * = required
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Parent/Caregiver's Information
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Emergency Contact if parent can't be reached (Name, Relationship, Phone)
Known allergies or other medical concerns:

RELEASE: I hereby release and agree to hold harmless First Baptist Church of Champaign at Savoy (FBC-CS) and designated leaders from all liability for damage, illness, or injury. In case of emergency, I give my permission for any necessary medical treatment. I will not hold FBC-CS or any leader/staff persons responsible for any injury that may occur.

I also give my permission to FBC-CS to use photos of my children, without any identification, in publications and/or on their website for promotional purposes.
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COST: $40/youth
Registration is not complete until payment is made.
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