BUMC Vacation Bible School - REGISTRATION
TRUTHSEEKERS: The Bible for Your Life

JUNE 13, 14 & 15
9AM to NOON
3 Year Old Through 5th Grade

**Note:  3 year olds must have turned three by January 1, 2022 and be potty trained**
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Parent's Name *
Phone *
Address (Street, City, State, Zip) *
Email Address *
Emergency Name & Number for during the event *
Child 1 (Name) *
Child 1 (Grade Completed Spring 2022) *
Child 1 (Age) *
Child 1 (Male/Female)? *
Child 1 (Date of Birth) *
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Child 1 (Allergies/Special Needs)
Child 2 (Name)
Child 2 (Grade Completed Spring 2022)
Child 2 (Age)
Child 2 (Male/Female)?
Child 2 (Date of Birth)
MM
/
DD
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YYYY
Child 2 (Allergies/Special Needs)
Child 3+ (Please provide Name, Grade, Age, M/F, Date of Birth, and any Allergy/Special Needs)
I give permission for photos taken of my child(ren) to be used for publicity purposes, such as brochures, newsletters, and web pages.  (E-SIGN YOUR NAME BELOW) *
The undersigned parent of registered minor(s), hereby grants permission for the registered child(ren) to participate in the activities at the church during this event.  I hereby grant to the leaders of the event full authority to secure such medical, surgical or hospital attention as may become necessary on an emergency basis to this child at cost to the parent.  Knowing that leaders of the activities will use their best efforts to make this event safe and rewarding to all concerned, I hereby release the said group leaders and BUMC from any and all claims which might result in providing medical services as described above or as a result of any actions taken by the group leaders in the course of their duties.  (E-SIGN YOUR NAME BELOW) *
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