Registration for FBC Bainbridge's Vacation Bible School 2016!
Please complete one form per participant.
June 20-24
Participant's First Name
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Participant's Last Name
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Gender
Grade Completed
Age
Address
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Parent or Guardian's Full Name
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Parent or Guardian's Email Address
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Primary Phone Contact
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Secondary Phone Contact
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Do you regularly attend a local church?
If you attend a local church, which one?
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Emergency Contact (18 years or older, please)
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Emergency Contact's Phone Number
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Other Adults Allowed to Pick Me Up
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Allergies or Other Information
If none, please specify.
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I am coming to VBS as a friend of...
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By clicking "yes" below, I the parent or guardian, hereby consent to my child named above participating in VBS at First Baptist Church. I understand that recreation time will include physical exertion, running, etc. If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them below. In the event an emergency occurs, I may be reached at the telephone numbers listed. If I cannot be reached, I hereby authorize First Baptist Church to make emergency medical decisions for my child. If there are any activities I do not want my child involved in, I have listed them below. I understand and hereby agree to assume all the risks which may be encountered during VBS, including activities preliminary and subsequent thereto. I do hereby agree to hold First Baptist Church and its agents, volunteers, and employees, harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities. I agree that my child’s image may be used in video and picture, for church or VBS activities or publicity.I expressly agree that this release, waiver and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Georgia and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital. 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.
Required
I do NOT wish my child to participate in the following...
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