NBC's VBS 2022 registration form
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Email *
Name *
Address: Street *
Address: City *
Address: Postal Code *
Address: State *
Birthday *
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DD
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YYYY
Gender *
Grade completed *
Please select child's T-Shirt size*T-shirts are provided for 4 yr olds through 5th grade. *
Please list any food allergies for this child. *
Is there anything we need to know about your child to help us serve him/her better? (i.e. medical diagnosis, family situation)* *
Emergency Contact Information     Parent's Name* *
Emergency Contact Information     Parent's Cell Phone #* *
Emergency Contact Information    Parent's email address:* *
Will you be on the NBC's campus during VBS times?* *
Photo Release:*     I am aware of the fact that photos of myself or my minor may be taken during the week by NBC staff, which may appear in future church publicity or church website.  By signing this, I give the permission to use these photos, aware of the fact that myself or my minor WILL NOT be identified in any such photos. PARENT/GUARDIAN:  If you have read and agree with the above statements, please type your full name below, understanding that this is a LEGALLY binding signature: First, Last Name: *
Waiver of Liability*      I, the parent and/or guardian of the above minor, hereby acknowledge that said minor is presently under my care, custody, and control.  I hereby give said minor(s), my express permission to attend and participate in all activities including transportation as provided by the NBC Kids Ministry.  I have listed my child's physical/medical concerns that may need attention and any special instructions/requirements regarding participation.  In the event of an emergency that necessitates medical, surgical, and/or dental attention, I hereby consent and give my permission to New Beginnings Church or its representatives, or any physician to make decisions and to perform such medical treatments and/or surgery upon said minor(s) which may, in their sole discretion, be necessary and proper under the circumstances.  I do release, acquit, discharge, and covenant to hold harmless New Beginnings Church and its representatives from any and all actions, damages, and liabilities arising out of participation or treatment of any sickness, accident, or injury incurred by said child while attending/participating in Children’s Ministry activities, physically demanding or not, and events.   I understand that my child(children) will be dismissed from participating in this activity and sent home at my expense (if applicable) if he/she fails to adhere to the rules. I also understand the following-  REGISTRATION for NBC Kids events/programs/camps is on a first come, first serve basis, and open until spots are full.  Please do not send your child to an event/camp/program with symptoms such as fever, cough, sore throat, nausea, diarrhea, loss of taste or smell, body aches, headache, shortness of breath, or any other symptom demonstrating illness. NBC Kids' staff primary mode of communication is email and I have provided an email address I check regularly.  I have provided an accurate phone number where I am reachable during the day in the event of an emergency.   I have read and fully understand the above permission for treatment/liability release and agree to its terms.   *
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