Bridgewater Community Vacation Bible School
2019 Registration/Emergency Care Form.
Please Complete One Form For Each Child (If under 4, guardian needs to stay with child)
Child's Name (First and Last) *
Your answer
Parent's Name(s) *
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email
Your answer
Emergency Contact Number/Name/Relationship *
Your answer
Date of Birth *
Your answer
Last Grade Completed *
Your answer
Allergies and Medical Conditions *
Your answer
How did you hear about Bridgewater Community VBS?
Your answer
I give permission for my child to participate in any or all activities led by the Bridgewater Community Church Bible School. *
If an emergency occurs and I cannot be contacted, permission is granted to take my child to the doctor or hospital at my expense. The medical staff is granted permission to provide the treatment necessary for the well-being of my child. *
I give permission for my child to be photographed or videotaped during the Bridgewater Community Church Bible School for the purpose of those photos/videos to be used in promotional material by the participating churches. I understand that my child’s name will not be included in any such material. *
Parent/Guardian name provided in this response confirms the information provided above is accurate. *
Your answer
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