Van Transport Registration Form Your Name (required) Your Email (required) Current Grade Age Birthday Address City/County State Zip Mother or Guardian Phone Father or Guardian Phone In case of emergency, notify: Phone **Phone numbers must be kept updated in case of emergencies. If your phone number changes throughout the year, please send your updated numbers with your child. I have read and understand the Rules, Expectations, and Consequences for the Church Bus/Van. I hereby authorize Kingsland Baptist Church members and leaders to transport my child by bus or by van to and from Kingsland Baptist Church to and from a previously designated church van/bus stop. In the case of emergency, I hereby authorize Kingsland Baptist Church program leaders to act for me according to their best judgment in any emergency requiring medical attention. I hereby waive and release Kingsland Baptist Church and its leaders and church members from any and all liability for any injury or illness incurred in the transportation to and from and participation in any Kingsland Baptist Church programs and activities. I acknowledge that all the medical information given on the program registration form is accurate and up to date. Name of Parent or Guardian Date * Departments Covered: Children’s and Youth Dept., All Programs- (July 2018 thru July 2019). This includes all AWANA Club Activities (Awana Games, Awana Game practices, Visits, Bible Quiz, Sparks A Rama, Hikes, Bowling, Golf, etc.), the 4th & 5th Grade girls “Keepers at Home Program” and boys “Contenders of the Faith” and all of their events, and Youth Activities.