Register for VBS

Family Information

Address

Primary Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Information

Birth Date

Age Group

Gender

Food Allergies

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Medical Concerns

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Liability Waiver By signing below, I, the undersigned parent or legal guardian, hereby agree to hold harmless and indemnify [Church Name], its employees, volunteers, and agents, from any and all claims, liabilities, or legal actions arising from or in connection with any accident, injury, illness, or other incidents that may occur during my child's participation in the Vacation Bible School (VBS) program. I acknowledge that there will be photography of the event and my child's image may be included. I acknowledge that I understand the inherent risks involved in such activities and voluntarily assume responsibility for my child's participation. I further waive any right to initiate litigation or seek damages against [Church Name] or its representatives related to any such incidents. This agreement is binding upon my heirs, executors, and assigns. To accept and sign, pease type your full name below. Liability Waiver

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