Vacation Bible School Registration
Vacation Bible School in Firth is back! Join us Monday, June 26th through Wednesday, June 28th from 6pm to 8pm. VBS is free and is for all potty trained 3-4 year olds to current 5th graders. If your child is eligible, please register below. For more information and or questions, please contact
Sign in to Google to save your progress. Learn more
Parent or Guardian's First & Last Name: *
Primary E-mail:  *
Primary Phone Number:  *
Parental Consent:
My child has permission, without restriction, to participate in all snacks, regular and special programming (including transportation), unless I notify LLRC in writing. I understand and realize Living Life Reformed Church will follow safety procedures, but that all physical activities include a certain risk and that LLRC assumes no liability for injury or damage arising from, or as a result of, participation. I affirm that I have been advised that any and all church activities include risks and dangers. These risks include, but are not limited to, loss of or damage to personal property, injury or fatality. I have assumed all of the above risks and intending to be legally bound hereby, will hold Living Life Reformed Church and their agents, servants, and employees harmless from any liability which may arise out of, or in connection with, any trips and related participation in any other activities arranged for by Living Life Reformed Church, their agents, servants and employees. The terms hereof shall serve as a RELEASE AND ASSUMPTION OF RISK for any minors.

In the event that I cannot be reached in an emergency, I herby give permission to the physician or dentist selected by LLRC to hospitalize, secure proper treatment for, and order injections, anesthesia, or surgery for my child. My child's physician or his/her office should be contacted, if possible.

I understand that LLRC reserves the right to dismiss any child if it is deemed necessary by the directors to be in the best interest of the child or program.

I give permission for Living Life Reformed Church to use my child's name, voice, testimonial, and/or picture in any type of promotional material, press release and news stories about Vacation Bible School or Living Life Reformed Church. I understand I can notify a director if this is unacceptable
Agreement: *
I have read and agree to the above and assume responsibility for my child and his/her actions.
Child's First & Last Name : *
Please fill out child #1's information
Gender: *
Birthday: *
Grade: *
List any allergies or other restrictions which may hinder your child's ability to fully participate in all Vacation Bible School activities. Include pertinent physical, psychiatric and behavior related information. *
Do you have more children to register? *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy