VBS - Summit Bible Church

Vacation Bible School Registration

July 10-12

6:30-8:30 PM

Age 3-Grade 5

Free/ No Cost

We’re launching kids on a cosmic quest where they’ll have a blast shining Jesus’ light to the world. Stellar rockets kids on an out-of-this-world adventure that’s light years of faith-building fun.

Vbs

Parent / Guardian

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Home Church (if any)

Would you like to add an additional Emergency Contact?

Yes

Additional Emergency Contact

Phone Number Emergency

Child's Information (1)

First Name

Last Name

Gender

Date of Birth

Grade

Does your child have any Medical or Allergy concerns you need to share?

Would you like to register another child?

Yes

Child's Information (2)

First Name

Last Name

Gender

Date of Birth

Grade

Does your child have any Medical or Allergy concerns you need to share?

Would you like to register another child?

Yes

Child's Information (3)

First Name

Last Name

Gender

Date of Birth

Grade

Does your child have any Medical or Allergy concerns you need to share?

Would you like to register another child?

Yes

Child's Information (4)

First Name

Last Name

Gender

Date of Birth

Grade

Does your child have any Medical or Allergy concerns you need to share?

I give permission for my child to participate in Vacation Bible School. I affirm that my child is in good health. I know of no reason(s), other than the information indicated on this form, why my child should not participate in Vacation Bible School activities. In case of a medical emergency, I give Summit Bible Church staff permission to secure transport for my child to a healthcare facility. I also give permission for the physician selected by Summit Bible Church staff to provide any treatment or procedure, as deemed necessary. I hereby assume all risks of my child attending Vacation Bible School. I agree to waive and release any and all past, present, or future claims against Summit Bible Church relating to my child's participation, including liability or damages from claims for personal injury or any other harm or loss. I Give Summit Bible Church permission to use images (such as photographs or videos) of my child for future promotions for Summit Bible Church and its ministries.