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VBS Registration

Parent / Guardian

Email

Street

City, St, & Zip

Main Phone

Other Phone

Child's First Name

Child's Last Name

Child's Birthday

Grade Completed

Medical Information

Home Church

Emergeny Acceptance

I hereby authorize the leaders of VBS to act on my behalf when I cannot be contacted, IN CASE OF AN EMERGENCY, resulting in the need of medical attention for my son/daughter named above. I also agree to hold harmless the VBS leadership and First Baptist Church of Silvis, IL, from any sickness, communicable disease, accidents, or injuries resulting from my child’s participation in its activities. Furthermore, I agree to reimburse First Baptist Church, Silvis, IL for all medical expenses.

Photo Acceptance

I understand that photographs will be taken throughout the VBS week which may be used as part of daily slide presentations. I hereby give permission for my child to be photographed. I further understand that if I do not wish my child to be photographed, it is my responsibility to notify the VBS Director.