top of page

Parents' Day Out 2023 Registration

Want to take some time out for Christmas shopping? Bring your children to our FREE Parents' Day Out event! We'll have a Bible lesson, games, movie, snack and lunch, and cookie decorating! They will also each get to make a special gift for Christmas, just for you! You are welcome to drop off and pick up any time during the hours of the event, 9:00 am - 2:00 pm.  Ages 3  - 12.  
Please complete the form below to register your child/children. Please submit a separate form for each child. If you have any questions, feel free to contact our office at 540-832-3269 or by emailing

Permissions & Releases

I understand that by registering, I am giving permission for my child/children to participate in ALL activities offered (i.e., Bible study, worship services, arts & crafts, music, recreation, games, meals & snacks, etc.). If I have specific concerns about activities that I may not want my child/children to participate in, I will notify the leaders before leaving my child/children in their care. 

All activities are done in a group situation. I understand that my child/children is/are expected to be on their best behavior and to follow all instructions and rules as given by the event leaders and volunteers.  If you or your child/children experience a problem or have concerns, please contact one of the leaders immediately to discuss so the situation can be resolved quickly. By signing you understand and agree that should there be a discipline problem, corrective measures may include time out, separation from the group, or assignment to an adult volunteer for 1-on-1 supervision. If after these measures have been taken and the child/children is/are still uncooperative or if the problem is severe and causing distress to the leaders or the other children in the group, the parent/guardian will be called for the child/children to be picked up immediately. 

I understand that Mechanicsville Baptist Church, hosting this Parents' Day Out event, as well as all leaders, and volunteers, have made every effort to provide a safe environment. If a child requires medication (prescription or nonprescription) or special medical equipment, this must be checked in with a volunteer for safe keeping during program activities. The volunteer will administer and document any medicine given as directed by the parent or guardian on this form.

If an emergency medical situation arises, I give full permission for the leaders and volunteers to administer first aid treatment to my child/children who are participating in program activities. If the situation is beyond basic first aid, I also give permission for the leaders and volunteers to seek immediate professional medical care for my child/children including transportation to the nearest clinic or hospital as appropriate. Parents or guardians will be notified of medical emergencies as soon as possible and kept informed until they can arrive. (While it is not necessary to provide a copy of medical insurance cards or a complete detailed medical history, if you child/children has a special medical condition which may require professional treatment, it may be helpful for leaders and volunteers to have this information on hand so medical providers can have it immediately in the case of an emergency.) I have provided all necessary information about any specific health conditions my child/children may have.

I understand that there are certain risks in recreation activities which are offered as part of participating in this program and I fully accept those risks and agree to my child/children participation. I understand that some of these risks are known and some are unknown and that the leaders and volunteers have done their best to provide a safe and fun environment. I acknowledge that Mechanicsville Baptist Church, hosting this event, the leaders, and the volunteers are not responsible for any harm or injury that might occur while participating in physical activities, such as sport-type games.


I fully release and discharge Mechanicsville Baptist Church, hosting this event, the leaders, and the volunteers from all liability in connection with my child/children participation in this event.

Photography & Videography Release


I authorize pictures/video of my child, named above, to be taken and uploaded on Mechanicsville Baptist Church social media accounts, which are Facebook and YouTube.  I authorize Mechanicsville Baptist Church to use my child's photo for future event promotion materials on social media or in print.  I understand I will not receive compensation for my child's photos or video if used online or in print.

Behavior Covenant

Any time a group of children gather, despite best intentions, there are opportunities for inappropriate behavior and times when discipline must be enforced. The following rules are intended to ensure safety, physical and mental well-being, organized travel, and peaceful co-existence for the entire group. Please take a few minutes to discuss these rules and appropriate behavior for attending the activities during Parents' Day Out.

  1. Treat everyone with respect. Obey instructions given by the leader or volunteer. 

  2. No inappropriate or foul language or gestures will be tolerated.

  3. Bullying, verbal harassment, physical harassment, and sexual harassment will not be tolerated by our children or against our children.

  4. Remain with our group and adult leaders at all times. Do not leave an area without an adult leader.

  5. The use of cell phones (talking, texting, taking pictures), iPods, mp3 players, handheld video games, etc., is not allowed during our programs. (Your child is welcome to bring a cell phone to the session, but it must be set to vibrate and not be used unless it is an emergency. If your child brings a cell phone, it is the responsibility of the child to keep up with it.) Leaders and volunteers are not responsible for lost or stolen devices.

Violation of these rules may result in the parent/guardian being contacted to come pick-up the child immediately. If you are contacted to pick-up your child, it is expected you will pick-up the child within 30 minutes locally.

Mechanicsville Baptist church does not and will not physically restrain a child, or use corporal punishment as a means of discipline.  All adult volunteers have a current background check and have successfully competed the Child Safety Training through an approved course.

bottom of page