Request edit access
Vacation Bible School 2019
* Required
Email address
*
Your email
Student Age
*
Your answer
Student Grade
*
Your answer
Mailing Address
*
Your answer
Date of Birth
MM
/
DD
/
YYYY
T-Shirt Size
*
Child Small
Child Med
Youth Small
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X - Large
Adult XX-Large
Other:
Parents / Guardian Names
*
Your answer
Special Meal or Food Allergies
*
Yes
No
If yes description of food not to serve student.
Your answer
I therefore release and discharge all liability for any harm or injury suffered directly or indirectly as a result of my child's participation in the Avenue VBS Program, whether or not resulting from negligence. I also give permission for the staff, representative, or volunteers of The Avenue to administer first aid or to seek medical care for my child during my child's participation in the program, including transportation of my child to a medical facility for additional treatment that appears necessary.By checking yes will be your signature to our waiver.
Yes
No
Clear selection
Cell Phone
*
Your answer
Emergency Contact Phone Number
Your answer
Email Address
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms