VBSREGISTRATIONFORM

(July6-10,2020)

FamilyName:___________________________________________________________________Mother’sName:______________________________________Father’sName:______________________________________

First Last First LastAddress:(Apt.#__________)Street:_____________________________________________City:___________________________PostalCode:_____________________________________HomePhone:______________________________________________Parent'sEmailAddress:_________________________________________or__________________________________________BusinessPhone:Mother:___________________________________Father:___________________________________CellPhone:Mother:___________________________________Father:___________________________________EmergencyContact(NameandPhoneNumber):____________________________________________________________________

HomeChurch:_________________________________HowdidyouhearaboutVBS?:_________________________________OWNTRANSPORTATION:YESNO BUSTRANSPORTATION:YESNOCircleaschoolbuspickuplocation:

ClaraHughesPublicSchool Dr.EmilyStowePublicSchoolNormanG.PowersPublicSchool DavidBouchardPublicSchoolSherwoodPublicSchool QueenElizabethPublicSchool

PHOTOGRAPHS:Igivepermissionformychild’s/children’sphototobetakentouseinatakehomecraftandasapartoftheDVDslideshowforFriday’sParents’DayProgram.Fromtimetotime,photos/videosofthechildrenaretakenduringtheprogramtouseinfutureinternalcongregationalmeetingstocelebratethefuntimeswehavehadatVBS(thesephotoswillnotbeusedonlineoroutsideofCalvaryBaptistChurch).Doyougivepermissionfortheuseofphotosforthesepurposes?GRADE6/7/8ONLY-PHOTO/VIDEOOPTOUT:Weoftentakepicturesatoureventstohelppreservememoriesandfostercommunity.Weassumetherighttousesomepicturestohelppromoteanawarenessofwhatgoesoninourministriesonourwebsite,Instagram,andinourpublications(newsletters,ministryupdatesandpromotions).PleasecheckthisboxifyoudoNOTwantimagesofyourchildrenusedintheseways.INCASEOFACCIDENTILLNESSORINJURYwhileattendingVBS:Everyeffortwillbemadetocontactparents.Itisunderstoodthatbypermittingmychild/rentoattendVacationBibleSchool(VBS),IamagreeingthatCalvaryBaptistChurchandanyoneactingonitsbehalf,willbereleasedfromanyliabilityforinjuriestomychild/renthatmaybeoccasionedatthechurchproperty,oronthebus.IgivepermissiontotheChurchStaff,DirectorandAssistantDirectorofVBStomakedecisionsincaseofanemergencyonbehalfofmychild/renwhenIamnotimmediatelyavailableforconsultation.SIGNATURE:__________________________________________________ DATE:___________________________________

COMPLETEREGISTRATIONONBACK

YESNO

YESNO

RegistrantsmustbeJKGrads(BirthYear2015)toGrade8Grads(BirthYear2006)Child#1:FirstandLastName:_______________________________________________________________________________Birthdate:Year:__________Month:__________Day:__________Gender:GirlBoySpecialNeeds/BehaviouralChallenges/Allergies:___________________________________________________________________DoesallergyrequireEpi-Pen?:YesNo1:1AssistanceRequired/NameofSupportPerson:_______________________FRIENDREQUEST-First/LastNameofFriend:______________________________________GradeofFriend:______________Child#2:FirstandLastName:_______________________________________________________________________________Birthdate:Year:__________Month:__________Day:__________Gender:GirlBoySpecialNeeds/BehaviouralChallenges/Allergies:___________________________________________________________________DoesallergyrequireEpi-Pen?:YesNo1:1AssistanceRequired/NameofSupportPerson:_______________________FRIENDREQUEST-First/LastNameofFriend:______________________________________GradeofFriend:______________Child#3:FirstandLastName:_______________________________________________________________________________Birthdate:Year:__________Month:__________Day:__________Gender:GirlBoySpecialNeeds/BehaviouralChallenges/Allergies:___________________________________________________________________DoesallergyrequireEpi-Pen?:YesNo1:1AssistanceRequired/NameofSupportPerson:_______________________FRIENDREQUEST-First/LastNameofFriend:______________________________________GradeofFriend:______________Child#4:FirstandLastName:_______________________________________________________________________________Birthdate:Year:__________Month:__________Day:__________Gender:GirlBoySpecialNeeds/BehaviouralChallenges/Allergies:___________________________________________________________________DoesallergyrequireEpi-Pen?:YesNo1:1AssistanceRequired/NameofSupportPerson:_______________________FRIENDREQUEST-First/LastNameofFriend:______________________________________GradeofFriend:______________Child#5:FirstandLastName:_______________________________________________________________________________Birthdate:Year:__________Month:__________Day:__________Gender:GirlBoySpecialNeeds/BehaviouralChallenges/Allergies:___________________________________________________________________DoesallergyrequireEpi-Pen?:YesNo1:1AssistanceRequired/NameofSupportPerson:_______________________FRIENDREQUEST-First/LastNameofFriend:______________________________________GradeofFriend:______________