VBS 2018
Please fill out a form for each child who will be participating from age 3 - completed 5th grade.

Vacation Bible School will be 5:30- 8:30 pm each night June 4-7 at Cordele First United Methodist Church.

For questions, please contact Kathy Minor, Director of Children's Ministries, at kathy@cordelefirst.com or
call 229-273-4586.

Email address *
Child's First Name *
Your answer
Child's Last Name *
Your answer
Parent/Guardian Name(s) *
Your answer
School Grade Just Completed *
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Parent/Guardian Email Address *
Your answer
Home Church (if any)
Your answer
Parent/Guardian Phone Number *
Your answer
Allergies or Medical Conditions *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Adults that may pick up child
Your answer
Child's Date of Birth *
Your answer
I give permission for my child to be photographed during church activities for publication in print and on the church website, social media pages, and e-mails. *
LIABILITY RELEASE: In consideration of Cordele First United Methodist Church allowing the Participant to participate in children's ministry activities, we (I), the undersigned, do hereby release, forever discharge and agree to hold harmless Cordele First United Methodist 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 Participant while involved in the children's ministry activities. We (I) the parent(s) or legal guardian(s) of this Participant hereby grant our (my) permission for the Participant to participate fully in children's ministry activities, including trips away from the church premises. Furthermore, we (I) [and on behalf of our (my) minor Participant(s)] hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. Further, authorization and permission is hereby given to said Church to furnish any necessary transportation (within the limitations of church insurance and the law), food and lodging for this Participant. The undersigned further hereby agree to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto. 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 under the provisions of the Medical Practice Act 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 pursuant to this authorization. EARLY RETURN HOME POLICY: Should it be necessary for our (my) child to return home due to medical reasons, disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility. TRANSPORTATION PERMISSION: The undersigned does also hereby give permission for our (my) child to ride in any vehicle driven by an approved ADULT chaperone while attending and participating in activities sponsored by Cordele First United Methodist Church. My child/youth and I understand that SEAT BELTS SHALL BE WORN AT ALL TIMES during transportation. *
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