Vacation Bible School Registration
Showdown on Mount Carnal - June 10 - 14, 2019
Children to be enrolled in VBS:
(Feel free to use multiple registration forms for families with more than five children.)
Please do not forget parental information and Consent below children's information:
Parent's First Name: Parent's Last Name:
Parent's First Name Parent's Last Name
Address: Address Line 2 (i.e. Apt #)
Address Apartment Number
City: State: Zip Code:
City State Zip
Emergency Contact Phone Number: Email Address:
Will attendees need a ride? Bus Ride?
If yes, we will contact you at the address and/or number above to confirm times for pick-up and drop-off.
Does any attendee have any medical concerns including food allergies?
(If yes, please elaborate and include the child's name.)
Medical Concerns
VICTORY BAPTIST CHURCH ACTIVITY WAIVER
The undersigned parent/legal guardian hereby gives permission to Victory Baptist Church (herein "the Church"), for my child or children (listed above) to take part in the following activity Vacation Bible School June 10-14, 2019. Should my child require immediate or emergency medical care while engaged in an activity sponsored by the Church, in my absence, I hereby grant the Church authority to release my child for medical treatment to such medical personnel as the Church determines appropriate under the circumstances.
In consideration for the privilege of allowing my child to participate in the above-named activity, I agree to release and hold harmless the Church, its officers and agents, from any liability to or responsibility for bodily injury, damage or illness to the above-identified child while participating in any youth athletic or social activity which may be directly or indirectly sponsored by the Church. Further, I agree to indemnify and hold harmless the Church, its officers and agents with respect to any claim asserted by or on behalf of my child as a result of bodily injury, illness, or damage.
PLEASE READ CAREFULLY, THIS PERMISSION SLIP IS A LEGAL DOCUMENT WHICH INCLUDES A RELEASE OF LIABILITY AND INDEMNIFICATION.
As the parent/guardian of the children listed above in this form, I give my permission for my child's picture to be placed on the Victory Baptist Church web and social media sites.
Only Vacation Bible School-related photos will be posted, and my child will not be identified by name on the website or social media. I can request that my child's picture be removed from the website or social media at any time.
Electronic Signature Agreement. By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions.
Do you accept the use of an electronic signature for both the permission slip for activity and the consent for taking and posting photos?
YES I AGREE TO THE USE OF MY ELECTRONIC SIGNATURE
Electronic Signature of Parent or Legal Guardian (Please Type Full Name)
