VBS 2023 - Online Child Registration

VBS 2023 - Online Child Registration

Please fill out the following info so that we can ensure your children's safety while they're with us.
Parents/Guardians' Info
First Parent/Guardian's Name*
First Last (e.g. Jane Smith)
Second Parent/Guardian's Name (if applicable)
First Last (e.g. Jane Smith)
Primary Phone Number*
Please enter a valid phone number.
Primary Email*
example@example.com
Secondary Phone Number (if applicable)
Please enter a valid phone number.
Secondary Email (if applicable)
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Info*
Include name, relationship to child, and phone number (e.g. Jane Smith, grandmother, 555-123-4567) Emergency Contact must be 18 or older
Child Info
Names and ages of the children who will be attending*
(e.g. Jaden, age 7)
Any allergies or medical concerns we need to know about?*
Follow-Up
How would you like us to contact you after VBS 2023?*

Phone call from a pastorEmail from a pastorVisit from a pastorNo follow-up at this time
Would you like to receive email updates from EAG? (Unsubscribe at any time)*

YesNo
Any further comments or questions?
Please sign and date the following statement of consent
I/we, the parents/guardians of the children listed in this form, hereby give my/our consent for my/our children to attend events being organized and/or sponsored by EAG Church. This consent form also gives permissions to seek whatever medical attention is deemed necessary. By my/our signing this form, we hereby release all EAG staff, leaders, directors, volunteers, and EAG Church from any and all liability for any injury, loss, or damage to person or property that occur during the course of our/my child's involvement.
E-Signature of Consent*

Clear
And that's it!

Just hit the "Submit" button below.
Should be Empty:

VBS 2023 - Online Child Registration

Parents/Guardians' Info

Child Info

Follow-Up

Please sign and date the following statement of consent

And that's it!