VBS Registration Form
Goshen Road Baptist Church   ~  VBS   ~    July 9th - 13th
6:00-8:30
Supper will be served at 6:00.
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Child's Name *
Parent's Name *
Mailing Address *
City, State        Zip Code *
Phone Number *
E-mail Address
Child's Birthdate
MM
/
DD
/
YYYY
Grade your Child Just Completed *
Please select the group for the last grade complete in school. *
Please list any medical or other information we need to know.  Please include any food allergies.
Emergency Contacts (list names and numbers) *
Dismissal Information - Who may pick up your child at the end of each VBS day? *
Do you attend a church regularly?
Clear selection
If so, list your home church
May we have permission to photograph/video your child? We usually have a craft with their picture on it and like to present a slide show of pictures on family night. *
Release of Liability
By completing this Permission and Waiver Form, I release the church and its ministers, leaders, employees, volunteers and agents from any claim that my child may have or that I may against them as a result of injury or illness incurred during the course of participation in this event. This release of liability is also intended to cover all claims that members of the child’s or my family or estate, heirs, representatives or assigns may have against the church or its ministers, leaders, employees, volunteers, or agents. I further agree to indemnify and hold harmless the church and its ministers, leaders, employees, volunteers, or agents from any and all claims arising from my participation in its activities and programs, or as a result of injury or illness of my child during this event.

Warning
Under Georgia law, there is no liability for an injury or death of an individual entering these premises if such injury or death results from the inherent risks of contracting COVID-19. You are assuming this risk by entering church premises.
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