VBS Registration

First Four Wednesday’s in June

From 6:30-8PM

Parent / Guardian Name*

First Last

Phone*

Email*

Address*

Street Address City State ZIP Code

Children

Child's Name	Actions

There are no Children.

Emergency Contact Name

Please list a friend or relative to contact in the event of an emergency and the parent cannot be reached.

Emergency Phone

Do you consent to the following terms?*

Yes, I agree to the terms.

In the event of emergency and the parent cannot be reached, I, the undersigned parent/guardian of the child(ren) listed above, do hereby authorize adult volunteers of
Bible Baptist Church as agent(s) for the undersigned to consent to any medical or surgical care advisable by any accredited physician or surgeon in an approved emergency clinic or hospital.

I further release from any liability Bible Baptist Church and any of its ministries, leaders, or volunteers in the event of an injury, accident or illness before, during, or after this event. This agreement does not apply to claims for intentional misconduct or gross negligence. I accept full responsibility for my child(ren)’s safety and actions and recognize that by their participation, they may be at risk of contracting COVID-19. I agree to hold harmless Bible Baptist Church, its leaders, and its volunteers from any lawsuit, costs, or claims due to injury, loss, or death from or related to COVID-19.

I, the undersigned, grant permission for Bible Baptist Church to photograph/video my child(ren) during this event and use such media for craft projects, slideshows, the church website, and/or the church Facebook page. I understand that no identifying information will be displayed.

By checking the box above, you verify that you are the parent/guardian of the child(ren)/ward(s) listed above, that you grant permission for your child(ren)/ward(s) to attend Summer Adventure Bible Baptist Church, and that you are in agreement to the terms listed above concerning medical care, liability, and photography.

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