VBS Registration Page – Oakhurst EVFree

VBS 2019 Registration
Parent/Guardian Name*
Email*
Day Phone*
Cell Phone
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Home Church
Number of Children being Registered*
Please enter a value between 1 and 5.
Child(ren) Information
Name*
Nickname
Birthdate*
Grade entering in Fall 2019*
Gender*
- Male
- Female
Name
Nickname
Birthdate
Grade entering in Fall 2019
Gender
- Male
- Female
Name
Nickname
Birthdate
Grade entering in Fall 2019
Gender
- Male
- Female
Name
Nickname
Birthdate
Grade entering in Fall 2019
Gender
- Male
- Female
Name
Nickname
Birthdate
Grade entering in Fall 2019
Gender
- Male
- Female
Emergency Contact
In case of an emergency and the parent or guardian cannot be reached, who would be contacted?
Primary Contact Name*
Relationship to Child*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Secondary Contact Name
Relationship to Child
Address
Street Address Address Line 2 City State ZIP Code
Phone
Medical Information
Childs Physician
Physicians Phone Number
Medical Insurance Carrier
Policy #
Please list any: Medical Conditions, Activity Restrictions, Drug/Food/Other Allergies:
Acceptance and Comments
Legal Stuff
LIABILITY RELEASE: This event is co-sponsored by Oakhurst Evangelical Free Church and Oakhurst First Baptist Church (referred to as "the Church" in these releases). I hereby release "the Church" and the above mentioned VBS Program and/or VBS leaders/Volunteers from liability in case of injury or illness to the above named Child(ren). The above named child(ren) has my permission to participate in the activities in the above named VBS Program. If I cannot be reached in the event of an emergency, I give permission for necessary medical care, to secure proper treatment and to order injections, anesthesia or surgery for the above named child(ren). I understand that all charges for service not billed to my insurance carrier will be billed to me as parent/guardian.
Medical Authorization
MEDICAL AUTHORIZATION: By checking acceptance below and SIGNING REGISTRATION the first day I hereby give permission to "the Church" Vacation Bible School staff/volunteers to secure any medical treatment that may become necessary. I acknowledge that Participant has my permission to fully participate in activities, except as otherwise noted on this registration form.
Photo Release
PHOTO RELEASE: I hereby grant to "the Church" and to its employees, agents and assigns the right to photograph me or my dependent and to use the photo and or other digital reproduction of him/her to other reproduction of his/her physical likeness for publication processes, whether electronic, print, digital, or electronic publishing via the internet.
*
- I understand and agree to the above terms of VBS participation.
Parent/Guardian Signature (First Day of VBS)

Oakhurst Evangelical Free Church and Oakhurst First Baptist Church

VBS 2019

REGISTRATION FORM

VBS 2019 Registration

Child(ren) Information

Emergency Contact

Medical Information

Acceptance and Comments

Equipping the Saints,
Edifying the Body,
Evangelizing the World.

Recent Sermons

Archives

Contact Info

Oakhurst Evangelical Free Church and Oakhurst First Baptist Church

VBS 2019

REGISTRATION FORM

VBS 2019 Registration

Child(ren) Information

Emergency Contact

Medical Information

Acceptance and Comments

Equipping the Saints, Edifying the Body, Evangelizing the World.

Recent Sermons

Archives

Contact Info

Equipping the Saints,
Edifying the Body,
Evangelizing the World.