VBS Kid Registration 2024
Please complete a form for EACH KID attending VBS (completed Kindergarten- completed 5th grade)
Sunday, June 9-Wednesday, June 12 from 6-8:30 PM
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FIRST NAME *
LAST NAME *
GENDER *
GRADE COMPLETED
*If your kid has not completed Kindergarten after the 23-24 school year, they are too young for VBS.*
*
DATE OF BIRTH *
MM
/
DD
/
YYYY
Does your kid have any allergies, medical conditions, or special needs? Please specify below. (We offer options for kids with special needs to attend VBS. We want to work with you to find the best options for your kid!)
Does your child have a friend they would like to be in a crew with? (Children are grouped into crews by grade and travel to stations with other crews in the same grade.)
PARENT/GUARDIAN FIRST AND LAST NAME *
PARENT/GUARDIAN CELL PHONE NUMBER *
PARENT/GUARDIAN EMAIL ADDRESS *
PARENT/GUARDIAN ADDRESS, CITY, STATE, ZIPCODE *
Emergency Contact First & Last Name (someone other than Parent/Guardian)
*
Emergency Contact CELL PHONE NUMBER
*
Emergency Contact Relationship to Kid *
Release of Liability
I, and my heirs, in consideration of my participation in the 2024 Getwell Church Vacation Bible School, hereby release Getwell Church, its officers, employees, volunteers and agents, and any other people officially connected with this event, from all liability for damage to or loss of personal property, sickness or injury from whatever source (including contraction and illness of COVID-19), legal entanglements, death or loss of money, which might occur while participating in this event. I am aware of the risks of participation. I understand that participation in this event is strictly voluntary and I freely choose to participate. I understand that Getwell Church does not provide any medical coverage for me. I verify that I will be responsible for any medical costs I incur because of my participation.
Please indicate your acceptance and "signature" of this Release of Liability by clicking the circle below.
*
Photo/Video Release
I hereby grant Getwell Church, its subsidiaries, licensees, successors and assigns, the right to use, publish and reproduce for all purposes, my name, pictures of me in film or electronic (video) form, sound and video recordings of my voice, and printed electronic copy in all media including, without limitation, cable and broadcast television and the internet, and for exhibition, distribution, promotion, advertising and in brochures and other print media. This permission shall continue forever unless I revoke it in writing. I waive any right to inspect or approve finished photographs, audio, multimedia or advertising recordings and copy or printed or electronic media that may be used.
Please indicate your choice and "signature" of this Photo/Video Release by clicking the appropriate circle below.
*
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