FBC Nogales :: VBS 2021 Registration
WHEN: July 19th-23rd, 2021
WHERE: Frank Reed Rd Nogales AZ 85621
QUESTIONS?: (520) 281-1677 or office@fbcnogales.org
Parent/Guardian Name: *
Phone# *
Email ID *
Your Address *
eg: 1916 N. Frank Reed Rd Nogales AZ 85621
Child Name *
Please fill one form per child - do not enter multiple child names here
Child age *
Allergies, medical conditions, or special needs:
Do we have your permission to photograph and/or videotape your child(ren) to post on our church website, Facebook page, or show during a church service?
We may take photos or video of children participating in various parts of VBS to post on our church website, Facebook page, or show during a church service. By Answering 'YES' you are granting us permission to do so.
Emergency contact phone number *
In case of an emergency, we will call this number
Other person(s) authorized to pick up your child(ren):
List the name of anyone you want to have permission to pick up your child(ren) from VBS.
Authorization *
I (we), the undersigned parent(s) or legal guardian(s) of the minor(s) listed below/on the reverse, grant permission for my child(ren) to participate fully in Vacation Bible School (hereinafter referred to as “VBS”) activities from July 5, 2021 – July 9, 2021 at The Church at Tubac. Further permission is hereby given to The Church at Tubac to provide emergency medical treatment in the event he/she is ill or injured. I do hereby authorize and consent to any reasonable medical treatment as deemed necessary by a licensed physician/medical personnel. It is understood that this authorization is given in advance of any specific diagnosis or treatment being required, but is given to provide authority and power to render care which the aforementioned physician/medical personnel, in his or her best judgment, may deem advisable. It is also understood that effort will be made to reach his/her parent(s), legal guardian(s), or emergency contact(s) prior to rendering treatment, but that any treatment will not be withheld if the aforementioned cannot be reached. I understand the nature of VBS and do hereby release The Church at Tubac, its staff, and representatives from any liability for accidents or injury sustained by my child in conjunction with VBS.
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