JULY 10th - 12TH

ages 4-12

deadlines to register:

june 30th with t-shirt
july 8th with no t-shirt

PAY $10 REGISTRATION HERE

VBS REGISTRATION FORM

Parent/Guardian's Name

First Name

Last Name

How many children are you registering?

PLEASE COMPLETE A NEW REGISTRATION FOR EACH CHILD AS PARENTAL/GUARDIAN/EMERGENCY CONTACT INFORMATION MAY VARY BETWEEN CHILDREN.

Child's Name

First Name

Last Name

Child's Age:

VBS is for children ages 4-12.

Child's T-shirt Size:

Child's T-Shirt Size:

Emergency Contact #1 Name

First Name

Last Name

Emergency Contact 1 Phone Number

(###)

###

####

Emergency Contact #2 Name

First Name

Last Name

Emergency Contact #2 Phone Number

(###)

###

####

Please list any allergies or medical issues that we should be aware of for your child. Please indicate which child has said medical issue.

By signing this form electronically I give permission for my child to participate at all activities relating to VBS. I therefore, release New Life Church of Jesus Christ and its volunteers/employees from liability in case of accident /or injury whether resulting in minor injury or loss of life from activities related to New Life Church of Jesus Christ. I also give consent that in the event me or my emergency contact cannot be reached I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency.