Centerville VBS 2024 -Adult Helper

Centerville VBS 2024 - Adult Volunteer

June 10-14 at Fairgrounds
Adult Volunteer

Over 18
Adult Helper

First NameLast Name
Age
T-Shirt Size
Any special needs? (Medical, allergies, dietary). If yes, please describe.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Home Phone
Cell Phone
E-mail
example@example.com
Home Parish/Church
Emergency Information
Emergency Contact's Name

First NameLast Name
Emergency Contact's Relationship
Emergency Contact Phone Number
Photo Release for Adult

The sponsoring churches of Common Ground and Centerville's Summer VBS has my permission to use my photograph publicly in VBS materials.

I understand the images may be used in print publiccations, online publications, presentations, websites and social media.

I understand no royalty, fee or other compensation shall become paybable to me by reason of such use.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Signature

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Centerville VBS 2024 - Adult Volunteer