VBS Registration
Register your child for Shipwrecked Vacation Bible School!
July 16-July 20
6:00pm-8:15pm
Signatures will be collected on opening night
Child's Name *
Your answer
Child's Age *
Your answer
Parent’s address *
Your answer
Parent's Name *
Your answer
Phone Number *
Your answer
Allergies *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Church You Attend *
Your answer
LIABILITY RELEASE: In consideration of Bible Baptist Church allowing the above child(ren) to participate in Vacation Bible School activities, we (I), the undersigned, do hereby release, forever discharge and agree to hold harmless Bible Baptist Church, its directors, employees, volunteers and agents (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the above child(ren) while involved in Vacation Bible School.Furthermore, we (I) [and on behalf of our (my) minor child(s)] hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in activities involved therein. As well as releasing the child(ren) if necessary for transportation to and from the Vacation Bible School location. We(I), the undersigned, do hereby release, forever discharge and agree to hold harmless Bible Baptist Church, directors, employees, volunteers and agents from any and all liability, claims or demands for accidental personal injury in the process of transportation. *
MEDICAL TREATMENT PERMISSION: We (I) authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child or youth pursuant to this authorization. *
PHOTO/PICTURE PERMISSION: I (we) give my (our) consent to Bible Baptist Church to use photo or video images taken of my (our) child(ren) in church brochures, advertisements for the church, on the website, in social media, and in other church publications as they see fit. I agree to hold harmless Bible Baptist Church from any liability which may result from the use of said picture(s). This form will apply throughout my (our) child(ren)’s tenure at Bible Baptist Church’s Vacation Bible School.**None of the photos to be taken will be for personal use. *
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