2024 VBS Registration

Student Information

Name (First and Last)

Birthdate

Gender Boy Girl

Completed Grade

Does this child have any medical conditions we should be aware of?

Please list any food allergies

Family Information

Parent/Guardian Name:

Parent/Guardian Phone:

This address will receive a confirmation email

Address

Home Church

Permissions

Name of Emergency Contact

Phone of Emergency Contact

Emergency Medical Authorization - I hereby authorize the leaders of Vacation Bible School to act on my behalf when I cannot be contacted, IN CASE OF AN EMERGENCY, resulting in the need of medical attention for my child named above. I also agree to hold harmless the Vacation Bible School leadership and First Baptist Church of Silvis, IL, from any accidents as a result of my child's participation in its activities. Furthermore, I agree to reimburse First Baptist Church, Silvis, IL for all medical expenses.

I Agree

Photography Release -I understand that photographs will be taken throughout the week of Vacation Bible School which may be used as part of the daily slide presentations. I hereby give permission for my child to be photographed. I further understand that if I do not wish my child to be photographed, it is my responsibility to notify the Ministry Director.

I Agree

2024 VBS Registration

Description

Please Fix the Following