Permission Forms
2015
Kid life
s
Coosada Baptist Church
P.O. Box 99
5687 Coosada Road
Coosada, Alabama 36020
(334) 285-4225
www.coosadabaptist.org
Important Information for Parents
of Terrific Tuesday Kids
I am very excited about the summer events planned for your child. Each event serves to create a
well rounded, more spiritual, and extremely pooped out from having fun, kid. I have made a list of
things to consider and know to help you prepare and take care of all aspects of the summer
events. Please take note of the following:
Kids Eligible to Participate
Children who are entering 1st grade through exiting 6th grade can participate. Those
children who are new 1st graders must be accompanied by an adult to each event.
Medical Release Forms
EACH child must have their own medical release form filled out and notarized.
*DO NOT PUT MORE THAN ONE NAME ON FORM * ---thank you!!
We have a notary on staff, but it would be awesome if you could handle this with your
bank. Call ahead if you are coming by the church to have it notarized, I cannot guarantee
the notary will be here.
Permission Forms
I must have you sign up for each event two weeks prior to event. Pool party only requires a
few days notice.
Deadline for sign up is on each permission form.
You may sign up online OR by turning in permission form to black box located across the
kids’ booth.
Cost of Events
The pool party is free, but there are cost for the other events. Please see each signup
sheet for amounts and dates due for each event. Make checks payable to Coosada Baptist.
Day of Event
Please come inside to sign your child in for each event. DO NOT JUST DROP OFF
OUTSIDE THE BUILDING. We want to keep them safe and we may have schedule
changes or other information we need to tell you.
Thank you, ahead of time, for allowing me to hang out with, grow in Christ with, and just giggle
with your child.
If you have any questions, please call me wk 285-4225/cell 224-1540 or email
[email protected] or [email protected].
Lauri Cox, Children’s Minister, Coosada Baptist Church
Coosada Baptist Church
Terrific Tuesday Medical Release Form 2015
Child’s Name: ___________________________________ Grade Entering: ________
Parent or Guardians Name: ________________________________________________
Address: _________________________________ City: ______________ Zip: _______
Home Phone: ________________ Work: ________________ Cell: _________________
Another person to contact in case of emergency if you cannot be reached:
Name: __________________________________ Relationship: ___________________
Home Phone: ________________ Work: ________________ Cell: _________________
Please list any allergies to foods, medicines, insect bites, etc. or any other medical
conditions that we need to know about: ______________________________________
________________________________________________________________________
Family Physician: _______________________________ Phone: __________________
Insurance Co.________________________________ Policy #____________________
Group #__________________________ Name on Card: ________________________
I hereby give permission for my child________________________________________
To go on Terrific Tuesday Trips with Coosada Baptist Church. Further I give my consent for the
church representatives in charge to obtain necessary medical attention and treatment in case of
sickness or injury to my child. I, the undersigned, do hereby verify that the above information is
correct and I do hereby release, and forever discharge all sponsors of Coosada Baptist Church
from any and all claims, demands, actions or cause of action, past, present or future arising out of
any damage or injury while participating on any of the Terrific Tuesday Trips of 2015.
Dated this _________day of________________ 2015 State of Alabama, County
of_______________________
Signature of Parent or Guardian____________________________________________
Notary Name: _____________________________
Notary’s Expiration: ____________________________
Please have this form notarized.
Pool Party
Date: June 2nd, meet at the Brown’s home.
Cost: Free
Time: 9:00 AM – 2:00 PM
Where:
Jim and Tracey Brown’s home
300 Bryant Road
Elmore, AL 36025
What to Bring: Lunch, Towel, wear bathing suit, and sunscreen. Snacks and
drinks provided.
Directions will be available at the Kids Booth or google address.
Deadline for Sign-Up: Sunday, May 31st
Children attending
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Parents Name: ____________________________________
Work Phone: ________________ Home: _______________
Cell Number: ________________
My permission is granted for the child (ren) above to participate in the
Terrific Tuesday event with Coosada Baptist Church staff and chaperones.
I release and discharge all sponsors from any and all claims, demands, or
actions arising out of these activities.
Parent’s signature: ________________________Date:____
Foot Golf
Tallapoosa Lake Golf Course, Montgomery
Date: June 16th – Meet at church, transportation provided
Cost: $8.00 for course play $3 ball rental CASH ONLY
(Bring sack lunch & drink)
Time: 9:00 AM – 2:00 PM
Meet at the church to leave at 9am. If you have a volleyball label it with
your child’s name and bring it, if not ball rental is $3.
Deadline for Sign-up: Tuesday, June 2nd
Children attending
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Parents Name: ____________________________________
Work Phone: ________________ Home: _______________
Cell Number: ________________
My permission is granted for the child (ren) above to participate in the
Terrific Tuesday event with Coosada Baptist Church staff and chaperones.
I release and discharge all sponsors from any and all claims, demands, or
actions arising out of these activities.
Parent’s signature: ________________________Date:____
J.O.Y. Day
Jesus Others You
Date: July 14th – at church
Cost: $8 per child to cover supplies and lunch
Time: 9:00 AM – 2:00 PM
Come dressed to study for Jesus, work for Others, and have fun for
Yourself. When you arrive you will pick 2 Tracks
(Pick one from each category)
Track 1: Discovery Lab, Soccer, or Kitchen Concoctions
Track 2: Indoor games, Cheer, or Drama
Deadline for Sign-up: Tuesday, June 30th
Children attending
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Parents Name: ____________________________________
Work Phone: ________________ Home: _______________
Cell Number: ________________
My permission is granted for the child (ren) above to participate in the
Terrific Tuesday event with Coosada Baptist Church staff and chaperones.
I release and discharge all sponsors from any and all claims, demands, or
actions arising out of these activities.
Parent’s signature: ________________________Date:____
Callaway Gardens
Date: July 28th – Meet at church, transportation provided
Cost: $7 for Child, $14 for parent, $10 per child for Aqua Island (optional)
Time: 8:00 AM – 5:30 PM
What to Bring: Sack lunch, towel, sunscreen, wear bathing suit covered by
comfortable clothes for activities prior to beach time. May bring extra
towel and cover up for ride home.
Deadline for Sign-up: Tuesday, June 14th
Children attending
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Name: ________________________ Grade Entering: ____
Parents Name: ____________________________________
Work Phone: ________________ Home: _______________
Cell Number: ________________
My permission is granted for the child (ren) above to participate in the
Terrific Tuesday event with Coosada Baptist Church staff and chaperones.
I release and discharge all sponsors from any and all claims, demands, or
actions arising out of these activities.
Parent’s signature: ________________________Date:____