KirkWood VBS (6-8 grade) Registration

KirkWood's Christians In Action Mission for the Congo (Middle School)

July 27-31, 2020 5:30- 8:00 pm (Dinner Provided)
Child's Name:*

First NameLast Name
Birth Date:*

MonthDayYear
Age:*
2020-21 School Year Grade level:*

Parental Consent

I hereby consent to let my child participate in the Middle School VBS at KirkWood Presbyterian Church in Yorktown! It is understood that every precaution will be taken for the safety and well-being of my child (including precautions for the current Covid-19 as advised by the state of Virginia), but in the event of accident or sickness, KirkWood Presbyterian Church, its staff and its volunteers are hereby released from any liability.
Do you have a KYG release form already on file?

YesNo
As parent/ guardian, I understand that pictures/video (individual and group) will be taken during VBS events. I give permission for my son's /daughter's picture to be used for church materials (newsletter, web page, calendars, power point, etc.) in highlighting activities.

I give permissionI do not give permission- please do not photograph
Child's Name of Consent:*

First NameLast Name
Parent/ Guardian's Name:*

First NameLast Name
Date:

MonthDayYearHourMinutesAM/PM Option
By submitting this form, I give consent to KirkWood Presbyterian Church to enroll and monitor the child above in their summer VBS Middle School Missions program.
Should be Empty:

KirkWood's Christians In Action Mission for the Congo (Middle School)