Denton First Vacation Bible School - 2019 Event Registration
Event Date: Monday - Saturday, June 10 -15, 2019
Event Time: 10:00 A.M - 12:30 P.M
Event Location | Address: Denton First Seventh-day Adventist Church| 11010 Hwy 377, Pilot Point, TX 76258
Event Cost: Free Registration|Admission
Event Contact Information: Email: dentonfirstvbs@gmail.com (Preferred) or Phone: 940-484-4889

Please fill out the actual Registration form below and remember to populate all fields. Thanks.

JAMI KINGDOM VBS
JAMI KINGDOM VBS Video
Registration | Participant Information
Parent|Guardian First Name *
Your answer
Parent|Guardian Last Name *
Your answer
Parent|Guardian Email Address *
Your answer
Parent|Guardian Mobile Phone Number *
Please enter your mobile phone number with numbers only. No dashes, spaces or parenthesis are allowed
Your answer
Parent|Guardian Mailing | Street Address *
Your answer
City *
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State *
Please enter 2 character State Code only (ex.TX, OK )
Your answer
Zip Code *
Please enter 5 digit Zip Code only
Your answer
Child's Registration Information
Child First Name *
Your answer
Child Last Name *
Your answer
Child Nick Name
Your answer
Child Age Category *
Child Allergies|Other Medical Conditions *
Please list all medical conditions and known allergies or enter "NONE" and "NO Known Allergies" below:
Your answer
Child with Special Needs *
If you select Yes below and would like to share any information regarding your child's special needs please contact us using the the contact info listed at the top of this event registration page to request a Special Needs Survey
Child's Emergency Contact Name|Relationship *
Please enter the First Name, Last Name and Relationship to Child for your Child's Emergency Contact in the the event the Parent or Guardian can not be reached.
Your answer
Child's Emergency Contact Phone Number *
Please enter the mobile phone number of your Child's Emergency Contact named above. Please enter the mobile phone number with numbers only. No dashes, spaces or parenthesis are allowed
Your answer
Releases| Disclaimers Information
Emergency Response Release Disclaimer *
As a registrant and/or participant in this event, I give permission to call 911 or contact other emergency response personnel or services in case of emergency for me or my children attending and/or participating in any or all activities affiliated with and occurring for this event.
Name, Voice, Statements, Images, Photos and/or Video Release Disclaimer *
As a registrant and/or participant in this event, I agree to release and allow the name(s), the voice(s), any statements, any images and/or likeness of me or my children captured in any drawings, illustrations, audio recordings, photos, and/or videos to be used in any and all types of private, public, social, marketing, email, written, radio, online, internet, website, advertising and/or media communications by the Denton First Seventh-day Adventist Church, the Texas Conference of the Seventh-day Adventist Church as well as any and all Members, Local Churches, Conferences, Unions, Divisions, General Conferences and/or other entities and/or persons that make up and/or are associated/affiliated with the Seventh-day Adventist Church.
Liability Release Disclaimer *
As a registrant and/or participant in this event, I agree to hold harmless, not find liable for any reason, and fully and completely indemnify and not hold responsible the Denton First Seventh-day Adventist Church and its members, the Texas Conference of the Seventh-day Adventist Church and its members as well as any and all Members, Local Churches, Conferences, Unions, Divisions, General Conferences and/or other entities and/or persons that make up and/or are associated/affiliated with the Seventh-day Adventist Church from any and all harm that resulted from or may have resulted from my or my children's registration and/or participation in this event.
Electronic Signature Information
Electronic Signature Agreement *
(Parent|Guardian Only) - My electronic signature below is confirmation that I have read and understand all the information on this event registration form. I certify all information submitted by me to register and/or participate in this event for myself and my children is true and correct.
Electronic Signature *
Enter Full Name of Parent|Guardian
Your answer
Electronic Signature Date *
Please enter the current date and time
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Time
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Sponsored By
Denton First Seventh-day Adventist Church | 11010 Hwy 377 Pilot Point, TX 76258
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