City Life Church: VBS Registration 2017
Thank you for registering for our Exciting 2017 Galactic Starveyors VBS @ City Life Church. Please complete the form below and we look forward to seeing you there. July 24-28, 6:00pm -9:00pm.
Email address
Child's Name & Age
Your answer
Gender
Date of Birth
MM
/
DD
/
YYYY
T-Shirt Size
Last Grade Completed in School
Required
Mailing Address
Your answer
Phone number
Your answer
Parent/Guardian Name
Your answer
Parent/Guardian Cell Phone Number
Your answer
Emergency Contact
Your answer
Emergency Contact Phone Number
Your answer
Medical Information ( please list any health issues or Food allergies )
Your answer
Dismissal Information: Who may pick up your Child at the end of the VBS Day?
Your answer
Media Release: Our City Life Photographer will be taking photos all week. Do you agree for your child to be part of our social media post and have their photo used for future promotions of the Church?
Required
I understand that reasonable precautions will be taken to safeguard the health and well being of the participants in this VBS and that I will be notified as soon as possible in the event of an emergency. In the case of sickness or an accident, I authorize and consent the VBS Team, or other associated volunteers of the VBS program to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that myself or other legal guardian(s) cannot be reached. I herby do release and forever discharge the Church from all manners of actions, claims, which I or the child named above shall or may have for any reason, arising during my child’s attendance of the VBS.
Your answer
Please E-Sign Below to confirm your registration ( TYPE FULL NAME OF PERSON WHO IS COMPLETING THIS FORM )
Your answer
DATE COMPLETED
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms