Tuesday Nights at Hero Headquarters
Registration for West Side Baptist Church's VBS 2017
Parent's Email Address
Your answer
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's date of birth *
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What grade will your child be in this fall? *
Your answer
Child's shirt size *
Child's home address *
Your answer
Parents' names *
Your answer
Number to reach parent during VBS *
Your answer
Allergies/ Medical Information/ other *
Your answer
Emergency contact (name and number) *
Your answer
Dismissal Information (Names of persons who may pick your child up from VBS) *
Your answer
Medical release: I, the undersigned parent/ guardian, do hereby grant permission for my child to attend West Side Baptist’s VBS. I hereby authorize West Side Baptist Church and its representatives to obtain or provide medical treatment, if deemed necessary, for my child in the event of an unforeseen injury or illness during VBS and do hereby hold West Side Baptist Church, as well as its representatives, harmless in the exercise of this authority. I acknowledge and understand that, should such an emergency arise, I will be responsible for any medical bills that may be incurred on behalf of my child for said injury or illness. *
Required
Photo Release: I, the undersigned parent/ guardian, hereby acknowledge that West Side Baptist Church has my permission to publish photos of my child during their services, on their website, or in any other publications they provide for the purpose of promoting local events. *
By signing your name below, you are electronically signing this form and agree that all information is accurate and whole, to the best of your ability. *
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