Altus 1st Methodist VBS 2026

Student Information

Name

First NameLast Name

Birth Date

MonthDayYear

Grade entering in Fall

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Format: (000) 000-0000.

Does child have any allergies, chronic illness, or medical conditions? If yes, please describe.

Please note: please plan to send a small snack if your child has special food needs

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by {Altus 1st Methodist} during VBS. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless {Altus 1st} and all its respective leaders, volunteers, and staff from any and all liability for injuries to said child arising out of participating.

In case of injury to said child, I hereby waive all claims against {Altus 1st} premises used to conduct the event. There is a risk of being injured that is inherent in all children recreational activities.

Medical Release and Authorization

As Parent and/or Guardian of the named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency.

Signature

T-shirts are available for pre purchase for $12 via PayPal link below. Please include sizes and names. Youth small - Adult 2XL

https://www.paypal.com/ncp/payment/2DU4BJN62ES8Q

PREORDER SHIRTS WILL BE DISTRIBUTED JUNE 8th on the 1st day of VBS.
T-shirt design