Vacation Bible School Registration

Registration Form
Child's Name: *

First Name Last Name
Birth Date: *

Month Day Year
Age: *
Grade Completed: *
Child's Gender: *

Parent/Gardian: *

First Name Last Name
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Home Phone:

Area Code Phone Number
Cell Phone: *

Area Code Phone Number
E-mail: *
Home Church:

Emergency Contact: *

First Name Last Name
Relationship to Child: *
Emergency Contact Phone: *

Area Code Phone Number
Who is Picking up Child: *
Special Needs / Allergies / Medical Conditions / Concerns: *

Photo Release Form

I agree that First Baptist may photograph and record my child/dependent's likeness and activities (Images)* during church-related activities. I grant the following rights to First Baptist: permission to use and re-use, publish and re-publish, the Image(s) taken during Church activities and Services. Use of the Images for editorial, commercial, trade, advertising, and any other purpose may be done in any medium not existing or subsequently developed, on the church website and on the Internet, and worldwide in perpetuity for the purposes stated above.

I waive my right to inspect or approve any editorial text or copy that is used in connection with the Images and release and discharge First Baptist from any and all claims for libel, invasion of privacy, or other tortuous act.

*Image means all photographs, film, or other recordings taken of youth/children as part of the youth/child group at First Baptist.
I have read the foregoing. I fully understand its contents, understand that this agreement does not expire, and confirm my agreement by signing below. I am over the age of 21 and have legal capacity to sign the release. *

I agree I disagree
Child/Youth's Name (Print) *

Clear
Parent/Guardian Name (Print) *

Clear
Parent/Guardian Signature and Date *

Clear
Parental Consent

I hereby consent to let my child participate in the First Baptist Church of Eatonton Vacation Bible School 2021. It is understood that every precaution will be taken for the safety and well-being of my child, but in the event of accident or sickness, First Baptist Church, its staff and its volunteers are hereby released from any liability.
Child's Name of Consent: *

First Name Last Name
Parent's Name: *

First Name Last Name
Date: *

Month Day Year Hour Minutes AM/PM Option
By submitting this form, I give consent to First Baptist Church of the child above.
Should be Empty:

Registration Form