Turn It Up VBS Registration Form
Full Name
*
First Name
Last Name
Age
*
Birth Date
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Address
*
Street Address
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Phone Number
*
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Area Code
Phone Number
E-mail
Grade just finished
*
Home Church
Emergency Contact Person
*
Emergency Phone
*
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Area Code
Phone Number
Parents/Guardians
*
Our church cares for the success and safety of each participant inside our children’s ministry. Does your child have an allergy, medical condition, learning difference, disability or any other special need that we should be aware of?
Check Yes or No
Yes
No
Please Describe:
Is your child going to ask friends to come to VBS? How many do you think will come?
By signing below, the participant’s parent/guardian acknowledges and accepts the risks of physical injury associated with participation in Vacation Bible School. The parent/guardian accepts personal financial responsibility for any bodily or personal injury sustained by the participant during VBS. Further, the parent/guardian promises to hold harmless the United Brethren Church and its representatives for any injury related to VBS.
If a dispute over this agreement or any claim for damage arises, the participant’s parent/guardian agrees to resolve the matter through a mutually acceptable arbitration process.
The parent/guardian also realizes that the child’s picture may be used during VBS programming, newspaper or in church publications. If you DO NOT want to have your child’s picture used in newspaper or publications please check the box.
I do not give permission for my child's picture to be used.
Parent/Guardian Signature
*
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