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FITZGERALD EVENT

April 2, 11 a.m. – 3 p.m.
Paulk Park Ball Park
120 Paulk Park Road
Fitzgerald, GA 31750

OneDay FunDay Registration

OneDay FunDay Fitzgerald Registration

Registration is required to attend the event. Deadline to register is March 27.

OneDay FunDay is provided by Mission Georgia, an initiative of the Georgia Baptist Mission Board in collaboration with Called to Care. If you have any questions, contact Lori Hancock at benhillirwin@iamcalledtocare.com or (229) 424-2805.

Fields marked with an * are required
Instructions: This form must be completely filled out. The information is vital to the health and well-being of the child.

PARTICIPANT REGISTRATION

Participant Name
Participant Name
First
Last

PARTICIPANT REGISTRATION

PARTICIPANT REGISTRATION

PARTICIPANT REGISTRATION

PARTICIPANT REGISTRATION

PARTICIPANT REGISTRATION

LEGAL GUARDIAN INFORMATION

Legal Guardian’s Name attending OneDay FunDay with children listed above:
Legal Guardian’s Name attending OneDay FunDay with children listed above:
First
Last
Legal Guardian Address
Legal Guardian Address
City
State/Province
Zip/Postal

Medical Information

Medical Insurance Coverage
I acknowledge that neither Georgia Baptist Mission Board, Called to Care, Inc., or Paul Park Ball Park shall provide medical insurance coverage for myself or the children I am bringing to OneDay FunDay. I acknowledge that all information provided on this registration is current and correct.
Medical Release
If the above listed children are injured during their participation in any OneDay FunDay activity, Georgia Baptist Mission Board, Called to Care, Inc., or Paul Park Ball Park do not assume any liability to provide or continue to provide any such services as required. I assume all responsibility for the wellbeing of my child during the event. Should the children listed above require transport to a medical facility as a result of an injury, I am financially responsible for such transportation and medical treatment costs. If any of the children listed in my care are injured during camp, it is my responsibility to immediately notify a OneDay FunDay volunteer. I hereby hold harmless and agree to indemnify Georgia Baptist Mission Board, Called to Care, Inc., or Paul Park Ball Park from any claims, causes of action, damages and/or liabilities, arising out of or resulting from said injury or medical treatment. I further agree to accept full responsibility for any and all expenses, including medical expenses that may derive from any injuries to the children listed above in my care that may occur during his/her participation at the OneDay FunDay.

I further acknowledge that this releases all participants and providers of the event from any responsibility or obligation to provide financial assistance or other assistance. I understand and acknowledge that this release binds myself, children listed above in my care, my heirs, administrators and personal representatives.

Other
I expressly agree that this content and release is intended to be as broad and inclusive as permitted by the laws of the state of Georgia in the United States of America., and that this release shall be governed by and interpreted in accordance with the laws of the State of Georgia. I agree that in the event that any clause or provision of this release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this release, which shall continue to be enforceable. This release shall be governed by and construed under the laws of Georgia.

I agree that any legal action or proceeding relating to this release as a result of myself or children listed in my care participating in the OneDay FunDay event shall be brought only in Ben Hill County, Georgia.

I also understand that I am consenting to my personal image being used in media such as still pictures and videos for the possible use of future social media, online, training, or reporting related to Mission Georgia, OneDay FunDay, the Georgia Baptist Mission Board and partnering organizations.

I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understand.

Verification *
I agree that providing the requested information and checking this box is the same as having signed my name.

Parent/Guardian Digital Signature

By filling out your name and today's date below, you are providing a digital signature. You are acknowledging that all of the information provided is accurate and affirming that you have the legal right to provide this information on behalf of the child as their parent or legal guardian.
Applicant Verification *
I agree that providing the requested information and checking this box is the same as having signed my name.

Program Participation Agreement for OneDay FunDay

I, the undersigned, hereby acknowledge that the children listed in my care and myself are able to participate in OneDay FunDay. It is my wish for the children listed above to participate in any and all activities. I release and forever discharge and hold harmless the sponsors, organizers, volunteers, and property site owners, specifically including, but not limited to Georgia Baptist Mission Board, Called to Care, Inc., or Paul Park Ball Park.

Once you submit this registration application, you will receive an email confirmation and a copy of your information. Your browser will also be redirected to the Called to Care website.