2019 Vacation Bible School
Join us on July 22-25, 2019 from 6 -8:30 PM at First Baptist Cadillac (125 Stimson Street).  For students 4 years-old through 5th grade.
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Family Name *
Family Mailing Address *
Family City *
Family State *
Family Zip Code *
Parent/ Guardian(s) Name *
Phone number (mobile preferred) *
Who should we contact in case of emergency? *
Phone number (mobile preferred) *
CHILD #1 INFORMATION
Child #1 Name
Child #1 Last School Grade
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Child #1 Gender
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Child #1 Age
CHILD #2 INFORMATION
Child #2 Name
Child #2 Last School Grade
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Child #2 Gender
Clear selection
Child #2 Age
CHILD #3 INFORMATION
Child #3 Name
Child #3 Last School Grade
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Child #3 Gender
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Child #3 Age
CHILD #4 INFORMATION
Child #4 Name
Child #4 Last School Grade
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Child #4 Gender
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Child #4 Age
Please note any special needs or concerns (allergies, medications, medical conditions, etc). Be sure to  indicate which child.
PARENTAL/ GUARDIAN CONSENT
by checking the statements below you are stating your agreement.
As a parent/guardian of the student (s) named within this registration form, I agree to hold harmless First Baptist Church and its agents, employees, counselors, and volunteers, and hereby release them from any liability due to injuries sustained by camper while participating in camp activities. *
Required
I authorize the adult(s) in whose care the student has been entrusted to consent to any emergency medical, surgical or dental treatment and hospital care. *
Required
I agree to pay for all costs and expenses incurred in connection with such medical, dental and hospital services required by the student. *
Required
Should it be necessary for student to return home due to medical reasons, disciplinary or otherwise, I assume responsibility for providing transportation. *
Required
I give authorization for the VBS staff to photograph or videotape my son/daughter for future use to promote church activities. *
Required
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