Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

CHURCH ACTIVITY - WAIVER OF LIABILTY READ CAREFULLY, THIS PERMISSION CHECK INCLUDES A RELEASE OF LIABILITY AND INDEMNIFICATION By selecting YES, I am the parent / legal guardian of the following child being registered for VBS at BETHEL BAPTIST CHURCH, 999 BETHEL CHURCH RD, MONROE GA 30655, and give permission for my child to take part in VBS activities supported by the Church. In consideration for the privilege of allowing my child to participate in the VBS activities, I agree to release and hold harmless the Church, its officers and agents, from any liability to or responsibility for bodily injury, damage or illness to the registered child while participating in any activity which may be directly or indirectly sponsored by the Church. Further, I agree to indemnify and hold harmless the Church, its officers and agents, with respect to any claim asserted by or on behalf of my child as a result of bodily injury, damage or illness. By selecting NO, I do not give permission for my child to take part in VBS activities supported by the Church.

Student Information

Gender

Birth Date

REGISTRATION NOTE:

Age Group

Food Allergies

Details

Medical Concerns

Details

T-SHIRT SIZE

PERMISSION TO USE IMAGES / VIDEOS By selecting YES, I hereby grant permission for BETHEL BAPTIST CHURCH, 999 BETHEL CHURCH RD, MONROE GA 30655, to record sounds, images, or video of my child while attending this VBS program. I also give permission for BETHEL BAPTIST CHURCH, at its sole discretion, to use these sounds, images, or video in publications (including print, websites, and social media platforms) owned by BETHEL BAPTIST CHURCH, in relation to this VBS program. By selecting NO, I do not give permission to use images and video of my child.

If your child has special needs, (DOWN SYNDRONE, WHEELCHAIR BOUND, AUTISM, ETC.) please check and give short description so that we may be prepared for their need(s). Thank you. SPECIAL NEED(S):

Details

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