VBS REGISTRATION FORM

Trinity Baptist Church

Vacation Bible School

4 years - 6th grade

June 9-13 From 8:30 to 12:30

320 N Washington St,
Ardmore, OK 73401
Phone: (580) 223-9553
VBS REGISTRATION FORM
Child's Name
Child's Age
Child's Birth Date

MonthDayYear
Date
Child's Grade
Food or Medication Allergies or Special Needs
Child's Name
Child's Age
Child's Birth Date

MonthDayYear
Date
Child's Grade
Child's Birth Date

MonthDayYear
Date
Food or Medication Allergies or Special Needs
Child's Name
Child's Age
Child's Birth Date

MonthDayYear
Date
Child's Grade
Food or Medication Allergies or Special Needs
Parent or Gardian's

First NameLast Name
Address
Home Phone
Work Phone
Mobile
Email
example@example.com
Preferred Contact Method
Emergency Contact 1
Phone
Emergency Contact 2
Phone
Doctor
Phone
DISMISSAL
Who may pick up your child?
Name
Relationship
Name
Relationship
Van Rider blankIs your child to be picked up at same location blank fields and text.
Pick up location blanks. Drop off Location blank.
Do you give VBS leader permission to photograph or film the minor(s) designated above in a manner or form for any lawful purpose associated with this VBS program.

YesNo
Does your child attend Sunday School blanks Is your child a guest? If so, who is your child a guest of blank.
Additional Information
I give permission for the above child or children to be transported by Trinity Baptist Church to and from VBS .

I hereby give my permission for all the children listed above to participate and attend Trinity Baptist Church or any of the church related functions to VBS. I understand that my children will be under adult supervision. I further understand that in signing this permission slip, I release and hold harmless Trinity Baptist Church and all other church related functions.

By signing this permission slip, I release and hold harmless its trustees, officers. employees, interns, and any volunteers from any liability, past or future, fully and completely. I authorize the staff or designated medical professionals and/or volunteers to administer emergency medical assistance if I cannot be reached.
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date
Trinity Baptist Church . 320 N Washington. Ardmore, OK. . (580)223-9553
Should be Empty: