POWER UP! VBS Registration Form
New Community Christian Church
Child Information
Child 1 Name *
Your answer
Child 1 Grade *
Grade student will enter next school year.
Medical Notes
Your answer
Child 2 Name
Your answer
Child 2 Grade
Grade student will enter next school year.
Medical Notes
Your answer
Child 3 Name
Grade student will enter next school year.
Your answer
Child 3 Grade
Medical Notes
Your answer
Child 4 Name
Your answer
Child 4 Grade
Grade student will enter next school year.
Medical Notes
Your answer
Parent/Guardian Information
Parent/Guardian Name *
Your answer
Parent/Guardian Phone *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Authorized Adults for Pickup/Dropoff *
Your answer
Photo Release
By entering New Community Christian Church for POWER UP! VBS, you are entering into an active recording environment, and your likeness may be captured in photographs and videos. By entering, you acknowledge giving consent to take, own and use images containing your likeness at it’s sole discretion in perpetuity for this church. If you do not wish to convey this consent, please contact a staff member immediately.
I have read and understood the above photo/video disclaimer. *
Required
I hereby give permission for images of my child(ren) named above, captured during POWER UP! Vacation Bible School at New Community Christian Church through video, photo and digital camera, to be used solely for the purposes of New Community Christian Church promotional material and publications, and waive any rights of compensation or ownership thereto. No photos of minors will include names in public publication.
By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of New Community Christian Church. Report Abuse - Terms of Service