VBS 2017: Galactic Starveyors
July 24th - 26th at First Friends Church
Child's Name (First and Last)
Your answer
Child's Grade (Just Completed)
Parent or Guardian Name (First and Last)
Your answer
Child's Address
Your answer
Primary Phone Number (Parent/Guardian)
Your answer
Address (Parent/Guardian)
Your answer
Email Address (Parent/Guardian)
Your answer
Child Allergies and/or Medical Information
Your answer
Medical, Liability, and Financial Releases
Medical Release: “In the event that I cannot be reached in an emergency during the date(s) specified on this form, I hereby give my permission to the physician or dentist selected by the church leader to hospitalize, to secure proper treatment, and/or to order injection, anesthesia, or surgery for my son or daughter as deemed necessary.” Liability Release: “By agreeing to this form, the parent or guardian agrees to assume and accept all risks and hazards inherent in church related activities. The parent or guardian also agrees to not hold the church, its officers or employees or volunteer leaders/assistants liable for damages, losses, or injuries to person or property listed above.” The parents or guardians understand that they are agreeing for the minor listed on this form and the agreement is both a medical and liability release. Financial Responsibility: Any damage done to any of the facilities used for the activity will be assessed to the individual’s parents or guardians whose child was responsible for such damage.
Required
Photo Consent
First Friends Church develops and/or participates in many media & electronic presentations that highlight various activities. These include: Video, Web pages, Computer generated presentations, Computer based productions to be transmitted. These presentations may be used for: Public advertising (newspaper, TV, etc.), FFC web page, Newsletters, Sunday morning presentations (with local weekly broadcasts), and/or Correspondence/Literature. I do hereby consent First Friends Church, to use pictures of the child included on this form.
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