BBB Registration | Ephrata Bible Chapel

B, B, & B Registration Form

Please take a moment to fill out this form for each one of your children. Please note that your child(ren) will not be permitted to participate without registering.

Parent First Name

Parent Last Name

Phone Number (Emergency)

Child's Name

Please indicate what type of protective gear your child will be reqired to wear while participating in the B, B, & B Obstacle Course. Required

Helmet

Knee Pads

Elbow Pads

No Gear Necessary

I hereby assume all risks in connection with the Boards, Bikes, & Blades, and I further release Ephrata Bible Chapel and the staff from all claims, judgments, and liability for any injury or damage that the child may have due to participation with B,B,&B, including risks connected therewith foreseen or unforeseen.

I understand what is involved with B,B,&B and I understand that I have the opportunity to call the staff and request further information. *Event Coordinator (717) 826-1484

Your Signature

Thanks for submitting! See you then!