BETHESDA BAPTIST CHURCH VACATION BIBLE SCHOOL STUDENT REGISTRATION FORM  2025
VBS Registration for all ages. Monday, June 23-28 (6:00pm-8:30pm).  If student is under 18 years of age, a parent or guardian's signature is required to register the child.
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2025 VBS Student Registration Form
STUDENT NAME  (e.g.,  John Hall) *
Adult Student check one box *
Required
Gender of Adult Student check one box
Age of Child check one. (A parent/guardian must be prepared to remain in class with any child having physical and/or special education needs) *
Required
Gender of Child check one box.
Address (e.g., 1808 Capitol Ave., NE Apt 3) *
City/State/Zip code (e.g., Wash., DC 20002) *
Telephone number of Adult Student/Parent or Guardian (e.g., 202-333-4445) *
Name of individual to contact in case of emergency *
Address of emergency contact  (if different from students address)
Relationship   (e.g., mother, father, sister, brother, aunt, uncle )
Mobile number of emergency contact  (if different from students address)
Does the student have any food allergies? If yes, please specify food allergies in the next box below. *
Required
List the food allergies (e.g., milk, peanuts, eggs)
I/My child will need transportation (provided for those who live within city limits more than 1 mile from the church.)  If no, please print names of persons  to pick up child in the next box below. *
Required
List names of persons to pick up child

READ CONSENT/WAIVER AND PHOTO RELEASE CERTFICATION:  I understand that Bethesda Baptist Church will not be responsible when children 6 years old or younger are picked up by persons under 12 years old. 

I hereby grant Bethesda Baptist Church permission to use my or my child’s likeness in a photograph, video, or other digital media (“photo”) and understand and agree that such photographs, videos, or other digital media may be displayed or presented at Bethesda Baptist Church, on its website, on its Facebook page, or in its programs or newsletters.   Please print name of adult/parent/guardian to authorize student participation at Vacation Bible School (VBS).

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