VACATION BIBLE SCHOOL - 2019
AMELON UNITED METHODIST CHURCH - REGISTRATION
Student’s Name : *
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Age:
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Parent(s)/Guardian(s) for child attendees: *
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Address: *
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E-mail:
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Phone Number (Home/Cell): *
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Photographic and Video Recording devices will be employed during this event and could be used for publicity or historical purposes in a print or web based media outlet (i.e. church website or Facebook). If you do not want you image to be used, please contact the event organizers and let the photographer/videographer know during the event. In order to protect the privacy of the children and youth attending the event, parents/legal guardians are asked to select the appropriate permission level below. (Please check the one which applies) *
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Authorizing signature *
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Allergies/Medical Information/other *
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Emergency Contact information - Primary Name: *
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Phone Number: *
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Secondary:
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Phone Number:
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Others who are authorized for picking up: *
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