VBS 2022
Spark Studios Vacation Bible School at Rockford Reformed Church
June 26-29, 2022 • 6-8pm

Calling all kids ages 3 years through those who are in (or have just completed) 5th grade! Join us for four nights at Spark Studios VBS, a faith-filled adventure where imagination is ignited and creativity is awakened.
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Child's First Name *
Child's Last Name *
Child's Birthdate *
MM
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DD
/
YYYY
Child's Grade *
Or the grade they just completed
Allergies or other medical conditions
Parent(s) / Guardian(s) *
Phone Number (in case of emergency) *
Email (for vbs updates or reminders)
Medical Release *
By submitting this form, I agree to the following: In the event that my said child requires the care of a doctor, and I cannot be reached, I consent to any medical treatment deemed necessary by a licensed physician or dentist. In the event treatment is called for which a physician and/or hospital refuses to administer without consent, I authorize any RRC adult leader in whose care my child has been entrusted, to give such consent for us if I cannot be reached by telephone. In the event it becomes necessary for that person to give such consent for us, I agree to hold such person free and harmless of any claims, demands or suits of any kind as long as the treatment is administered by or under the supervision of a licensed physician or dentist. I also agree to pay all costs and expenses incurred with such medical and dental services rendered to the child. In the event that my child would need to return home from an off-campus activity due to medical reasons or otherwise, the undersigned shall assume all transportation costs, if applicable. MEDICATIONS: RRC staff and volunteers will not distribute medications to minors, including pain relievers for headaches, etc., without the written consent of a parent or guardian. Please send a signed note with specific instructions if the need arises.
Image Release *
I give Rockford Reformed Church (RRC) permission to use my child’s photo or likeness for purposes including, but not limited to, the church website, facebook page, or other church publications. I also release RRC, its employees, and/or volunteers from any liability in relation to the taking and/or displaying of any photographs/videos. The child's name will NOT be used with any photos.
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