Vacation Bible School Registration FormGreater White Rose ChurchMonday, June 9th- Friday, June 13th5:30-8:30 PMFree to all children ages 3-17. Child's First Name Last Name Age * Grade * What grade will your child be attending in the upcoming school year? Pre K- Kindergarten 1st-3rd 4th-6th 7th-8th 9th-12th Parent/Guardian Name * Parent/ Guardian Phone * (###) ### #### Allergies/ Other Medical Conditions Alternate Emergency Contact Name * Only to be contacted in case parent/guardian cannot be reached. Emergency Contact's Phone * (###) ### #### Release of Liability, Medical Consent, Photo/Media Release * By checking this box, I, the parent or legal guardian of the child named above, give permission for my child to participate in Vacation Bible School at Greater White Rose Church. I understand that reasonable precautions will be taken to ensure the safety of all participants. I hereby release Greater White Rose Church, its staff, and volunteers from any liability for injuries, accidents, or other incidents that may occur during VBS activities. In the event of an emergency, I authorize Greater White Rose Church staff or volunteers to obtain and consent to medical treatment for my child, including transportation to a medical facility, if necessary. I understand that I will be contacted as soon as possible in such an event and that I am responsible for any medical expenses incurred. I also grant permission for Greater White Rose Church to take photographs and/or video recordings of my child during VBS activities for use in church and ministry-related publications, social media, slideshows, and promotional materials. I understand that my child’s name will not be used without additional permission. I authorize Greater White Rose Church to act on the conditions stated above. Name * By typing your name, you acknowledge that this will serve as your electronic signature and that you are providing consent as the parent or legal guardian of the child named above. Date MM DD YYYY Thank you!
