Request edit access
Scuba VBS 2024
Event Dates: 
July 8-11, 5-8PM 
Family Celebration - July 12th, 6PM

Event Address: 
Lutie Watkins Memorial Methodist Church
800 Wright Street

Event Details:
  • FREE Event with Dinner Provided
  • Open to students Entering Kindergarten through Entering 5th Grade
  • Drop off & Pick Up at Family Life Center
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Grade Entering *
Allergies (please include food and environmental and the type of reaction we should to be aware of) *
Dietary Restrictions *
Any other Health Concerns that we should be aware of? *
Parent Contact Name *
Parent Contact Phone Number *
Emergency Medical Release
In the event of an emergency where medical treatment is required, I authorize Lutie Watkins Memorial Methodist Church personnel to take my child to the hospital for emergency care.

I release Lutie Watkins Memorial Methodist Church, the church staff, and VBS volunteers from responsibility in the case of an accident or illness which might occur in connection with the VBS program.
Medical Release Agreement
Clear selection
Emergency Contact Name *
Emergency Contact Phone Number *
Photo Release
By clicking I AGREE below, I hereby grant permission to Lutie Watkins Memorial Methodist Church (LWM) to use my child's photograph(s) on its website or in other official church publications with out further consideration. I acknowledge the church has the right to crop or treat the photograph(s) at its discretion. I acknowledge that the church may choose not to use my child's photograph(s) at this time, but may do so at its own discretion at a later date, up to 10 years from the date the photograph was taken. I understand that once my child's image is posted on the church's website and/or social media platform, the image can be downloaded by any computer user anywhere in the world. Therefore, I agree to indemnify and hold harmless the church, its trustees, pastor, associate pastors, or its members and designees from any claims arising out of the use of my child's photograph(s).  
Photo Release Agreement
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of LutieWatkinsMemorialMethodist.

Does this form look suspicious? Report