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Vacation Bible School at FBC
This program explores the beauty of the Himalayas and looks into truths and values from the Bible.
This program is free and for kids ages 5-12 years of age.
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Child's Information
(Fill out a separate form for
each
child)
Name:
*
Your answer
Address:
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Your answer
Birthdate (MM/DD/YY):
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Your answer
Health Card Number:
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Your answer
How did you hear about the program?
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Your answer
Parent/Guardian Information
Name:
*
Your answer
Address:
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Your answer
Phone Number:
*
Your answer
Emergency Contact
Name:
*
Your answer
Phone Number:
*
Your answer
Relationship to Child:
*
Your answer
In the case that you are not able to pick-up your child at the end of club, list the
individuals
that you give
permission to sign your child out:
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Your answer
Are there any
physical, emotional
or
mental
concerns that we should be aware of?
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Your answer
Does your child have any
allergies
that we should be aware of?
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Your answer
General Information
The Parent/Guardian signing this form has legal custody over the child. Conditions of custody, if applicable, will be fully communicated to the club leader, including a photocopy of the section of any court order referring to visitation rights.
Every precaution is taken for the safety and good health of the child at the program during transportation, but in the event of an accident or sickness, CEFOntario including the board, staff and volunteers are hereby released from any liability.
The Club Director and Club leaders reserve the right to dismiss a child who is a hazard to the health and safety of others, or have appeared to reject the reasonable controls of the ministry.
All children or their parent/guardian assume liability for any damage to property.
I have read through the application and accept the conditions of enrolment and cancellation for my child to go to participate in 5 day club/VBS.
CEFOntario and First Baptist Church may use any photography or video footage my child appears in for promotional purposes:
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Parent/Guardian Name:
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Your answer
Date:
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