VBS Child Registration Form

June 17-21 6-8:30PM | This form may be filled out for up to three children. Each section is required. If you have only one child, you will choose NA or not applicable for those sections. If you have more than 3 children, please fill out another registration form for them. All children on one form must have the same parent(s) or guardian. Thank you!
 
Child Information
 
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Emergency Contact Information
 
 
 
 
 
 
Parent/Guardian Information
 
 
 
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Other Information
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Consent for Participation, Medical Treatment, and Photo/Release
I am the parent or legal guardian of the above named child and I give permission for my child to attend Vacation Bible School at The Mission Church of Lexington and participate in all VBS activities. I authorize all medical, surgical, diagnostic, and hospital care or procedures which may be performed or prescribed for the above named child by a licensed physician or hospital, when efforts to contact me are unsuccessful and when deemed immediately necessary or advisable by the physician to safeguard my child’s health. I acknowledge that The Mission Church of Lexington will not be responsible for medical expenses incurred. I give permission for the above named child to be photographed during VBS, and for the images to be published, reproduced or distributed by The Mission Church of Lexington in all outlets, including, but not limited to, internet and church publications, without liability or limitation on my or my minor’s part.
 

Description

June 17-21 6-8:30PM
This form may be filled out for up to three children. Each section is required. If you have only one child, you will choose NA or not applicable for those sections. If you have more than 3 children, please fill out another registration form for them. All children on one form must have the same parent(s) or guardian. Thank you!