Casino Road VBS - Registration
Family Name *
Your answer
Child Name & Age
Your answer
Child 2 - Name & Age
Your answer
Child 3 - Name & Age
Your answer
Child 4 - Name & Age
Your answer
Child 5 - Name & Age
Your answer
Phone *
Your answer
Email
Your answer
T-Shirt Size & Quantity (Small, Medium, Large)
Your answer
Emergency Contact
Your answer
Does your Child have any Allergies?
In the event of an emergency, or a situation that is reasonably considered to be an emergency, I, ___________________________________the parent/guardian give permission to South Everett Foursquare to seek and authorize emergency medical care to be given to my child or children named above. (For example; first aid, medication, anesthesia, or surgery.) This care may be given under whatever conditions are necessary to preserve life, limb, or well being of my dependent. South Everett Foursquare church will make reasonable attempts to notify parents/guardians prior to authorizing any such emergency care. *
Your answer
I fully understand that my child must abide by all rules governing conduct and safety while attending Casino Rd VacationBible School Program activities.Additionally, I give permission for my child to be photographed during activities associated with Casino Rd Vacation Bible School.
I understand that said photos/videos may be used for the Casino RD VBS program, and that my child’s name will not be used with the image.
Parent/Legal Guardian Name__________________________________________ Phone (home) ____________________________ (cell)________________________ Text? Parent/Legal Guardian Signature______________________________________ Date ______________________
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service