VBS Camp Firelight Registration 2024

Emergency Contact:*

First NameLast Name
Emergency Contact Phone:*

Area CodePhone Number
Authorization for Media Release:

Spider Lake Church may post a photograph and/or video of my child/children on the church's website or use a photograph of my child/children in their publications, media, and/or on the screen at church. I understand that photos and videos will not be labeled with names.I ask that Spider Lake Church not post photographs and/or videos of my child/children on the church's website or publications.
Who will Pick up Child/Children:
Relationship to the child/Children:

Parental Consent: I hereby consent to let my child participate in the event, VBS "Camp Firelight." 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, Spider Lake Church, its staff and its volunteers are hereby released from any liability.
Child's Name of Consent:*

First NameLast Name
Child's Name of Consent:

First NameLast Name
Child's Name of Consent:

First NameLast Name
Child's Name of Consent:

First NameLast Name
Parent/Guardian Name:*

First NameLast Name
Date:

MonthDayYearHourMinutesAM/PM Option
By submitting this form, I give consent to Spider Lake Church for the child/children above.
Should be Empty:

Registration Form