Vacation Bible School - Registration
July 25-27, 2021 - Ages 4-12
July 28-30, 2021 - Ages 12-19
6:00pm-8:00pm Each Night
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Student's First Name *
Student's Last Name *
Date of Birth
MM
/
DD
/
YYYY
Gender
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Days Attending *
Bus # or Drive-In
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Address
City
State
Zip
Best Contact Number
Church That Student Regularly Attends
PARENT/GUARDIAN INFORMATION
Parent/Guardian Full Name *
Best Contact Number
SECONDARY EMERGENCY CONTACT INFORMATION
Secondary Emergency Contact Full Name
Best Contact Number
MEDICAL INFORMATION
Student's Allergies or Medical Conditions
Persons Other than Parent Authorized to Pick Up Student from VBS
Parent/Guardian Signature *
I, as parent/guardian of the above listed child, hereby grant permission necessary to allow child to participate in activities (including Vacation Bible School) conducted by New Hope Baptist Church (NHBC) and to be transported to and from those activities by the staff, volunteers, and vehicles of NHBC. I further agree to release and hold harmless NHBC from any liability or any claim judgment, loss, cost, and expenses arising out of or connected with NHBC, including any claim arising out of or connected with any illness or injury (minimal, serious, catastrophic, and/or death) that the child may incur or sustain during activities associated with NHBC or while traveling to, within, and from the activities. I authorize NHBC to obtain medical treatment for the child if deemed necessary by the staff or designated volunteer of NHBC and hereby release and hold harmless NHBC in the exercises of this authority. I understand that as a participant and/or spectator at NHBC activities that the child may be included in video recordings or photographs taken during the activities. Therefore, I grant permission to NHBC to use such materials as deemed appropriate by the staff.
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