2018 Sports Day Sign-ups

Sunday October 21, 1-5p | Please fill out this form and click submit.
Join us for a fun day of Fellowship! Competition! Games! Raffle Prizes!! FOOD!! Volleyball Games will the main competition.

Please remember to bring a water bottle, comfortable clothes and shoes, and maybe even a beach chair or blanket to sit on!

When: 10/21/18 1PM to 5PM
Where: Woodbridge Community Park (20 Lake Rd, Irvine, CA 92604)
Cost: $10 (13 years and up) and $5 (3-12 years)

Questions? Please email bereanlogistics@gmail.com

**Please submit a separate entry for each adult. Children's info can be submitted under one parent's entry**
 
 
 
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Medical Acknowledgments and Release Form

This aforementioned registration information and health history is true and correct to the best of my knowledge. I hereby give my full consent to Berean Community Church and its officers to seek and administer treatment for any injuries and/or illnesses that I might sustain while participating in the 2018 Berean Sports Day activities and while under super- vision as a participant in said activities, including transportation to and from any facilities necessary for proper treatment. I understand that Berean Community Church will select a qualified physician, nurse, dentist, or other certified medical professional to administer treatment.
As a participant, I understand that Berean Community Church is not obligated to carry any insurance to cover those medical and/or dental expenses. If such insurance is carried, coverage will be provided only for expenses in excess of the limits of the participant’s existing insurance coverage. I understand that my personal health insurance is my primary coverage for all occurrences while participating in the 2018 Berean Sports Day.

I desire to participate in the activities at Berean Community Church. In consideration of Berean Community Church providing these activities, I do hereby release Berean Community Church, its officers, employees, agents, and members from all claims and causes of action by reason of any injury or illness which may be sustained as a result of these church activities, whether on church premises or on the way to or from these activities.

This authorization shall remain effective until revoked in writing and delivered to Berean Community Church.
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Payment

Cost: $10 (13 and up) and $5 (12 and under)

Put "SPORTS DAY 2018" in memo line:
Check (payable to "Berean Community Church")
Venmo - @bereanccpay
PayPal - bereanccpay@gmail.com (DO NOT CHECK Goods and Services box)
Zelle (formerly Chase) - bereanccpay@gmail.com
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Description

Sunday October 21, 1-5p
Please fill out this form and click submit.