VBS 2022

VBS 2022 Registration

This VBS is for children Kindergarten through 8th Grade. Register by grade completed May 2022 Kindergarten - 8th Grade.
Child Information
Child's Name *

First Name Last Name
Child's Gender *
Child's Age *
Age during VBS.
VBS is ONLY for children in grades Kindergarten through 8th grade. No Pre K children can be registered.
Child's Grade *
Grade completed May 2022. Must have completed kindergarten to register.
Please select yes below if your child has any food allergies, physical limitations or restrictions, communication needs, or anything else that will help us to help your child have the best possible week at VBS. If you select yes, we will contact you for more information.
Follow Up Call *

Yes No
Transportation Information
How will your Child be coming to VBS *
Transportation is available for children who have completed Kindergarten and up. By choosing church provided transportation, I release Faith Community Church, and any of its representatives, whether paid staff or volunteer, from any and all liability where the transportation of my child via church provided transportation is concerned.
Transportation Other
Parent Information
Parent Name *
First & Last Name
Email *
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How did you find out about VBS? *
Home Church *
Emergency Contact

Please provide the name and phone number of someone we can call if we cannot reach you.
Emergency Contact Name *
Phone Number *

Area Code Phone Number
Authorization
In case of emergency, every attempt will be made to contact a parent/guardian. If parent/guardian cannot be found, I hereby give permission to the medical personnel selected by Faith Community Church to order any necessary x-rays, tests, treatment; to release any records necessary for insurance purposes; and to provide or arrange necessary related transportation for my student. I also hereby grant permission for Faith Community Church to transport my child, if necessary. I also give permission to the physician selected by the church to secure and administer treatment, including hospitalization, for my child. I hereby agree to be responsible for payment of all costs and expenses of any health care provider or other person who acts in reliance upon this consent and authorization for treatment.

I hereby grant permission to Faith Community Church to record, by videotape, photograph or other means of reproduction, voice, image and physical likeness of my child and to use any such recorded matter for promotional purposes without further consent or compensation.

I grant permission to Faith Community Church to use my email address to send me daily summaries of events during VBS and to notify me of future events at Faith Community Church.

I grant my child permission to participate in VBS activities and covenant with Faith Community Church that I will never institute any action against Faith Community Church in regard to any personal injuries or injuries to property.

I understand and acknowledge that VBS activities, including church provided transportation, have inherent dangers that no amount of care, caution, instruction or experience can eliminate, and I expressly and voluntarily assume all risk for personal injury sustained by my child while participating in these activities whether or not caused by the negligence of the released parties.
Authorization for Participation *
I give my child permission to participate.
Signature

Please use your finger or mouse to sign this form. Clear
Please fill the text as shown *
Click submit below to finish registering your child. You will have the option to register another child after you click submit.

If you have any questions please email vbs@faithccpalmer.org
Should be Empty:

VBS 2022 Registration

Child Information

Transportation Information

Parent Information

Emergency Contact

Authorization