VBS Registration

Child's Full Name

Birthday

School Attended

Silo Durant Kingston Calera Colbert Homeschool Other

Last School Grade Completed

Parent/Guardian Name

This address will receive a confirmation email

Phone

Address

Home Church (If Any)

Emergency Contact other than Guardian/Parent listed above

Emergency Contact Phone

Special Needs/Allergies/Medical Information/Other:

In consideration of Emmanuel Baptist Church in Mead, OK allowing the above child to participate in Vacation Bible School activities, I, the undersigned, do hereby release, forever discharge, and agree to hold harmless Emmanuel 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 while involved in Vacation Bible School. Furthermore, on behalf of my minor child, I hereby assume all risk of accidental personal injury, sickness, death, damage, and expense as a result of participation in activities involved therein.

I agree

Emmanuel Baptist Church/VBS has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

I agree

VBS Registration

Description

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