Vacation Bible School Registration Form

Child Information

Child 1*

First NameLast Name

Last Grade Completed*

Add Child

Child 2*

First NameLast Name

Last Grade Completed*

Child 3*

First NameLast Name

Last Grade Completed*

Child 4*

First NameLast Name

Last Grade Completed*

Child 5*

First NameLast Name

Last Grade Completed*

Parent/Guardian Information

Parent/Guardian's Name*

First and Last

Phone Number*

E-mail*

example@example.com

Address*

Street Address

Street Address 2

CityState

Zip Code

Authorized Alternate Pickup

Other than Parent or Guardian listed, who may pick up your child at the end of the evening?

Name*

Relationship*

Name (Optional)

Relationship (Optional)

Name (Optional)

Relationship (Optional)

Does the child(ren) have any allergies, chronic illness, or medical conditions? If yes, please describe.*

Is the child(ren) prescribed an inhaler? If yes, please explain any instructions.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Holiday Hill Church during Vacation Bible School. In exchange for the acceptance of said child’s candidacy by Holiday Hill Church, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Holiday Hill Church and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from Vacation Bible School sessions.

In case of injury to said child, I hereby waive all claims against Holiday Hill Church including all teachers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Initials*

Media Release

By submitting this form and registering my child(ren) for Vacation Bible School (VBS), I understand and agree to the following:

My child may be photographed, video recorded, or appear in livestreams during VBS activities.

These images or recordings may be used in church-related materials, including:

Church website
Social media (e.g., Facebook, Instagram)
Printed/digital promotions
Slideshows or recap videos
Livestream broadcasts

My child’s name will not be used without additional written consent.

I release Holiday Hill Church from any liability related to the use of this media, and I waive any right to inspect or approve the final products.

By dropping off my child at VBS, I consent to this media release.

If I do not consent, I will notify the church in writing before my child attends.

Media Consent*

I have read and agree to the media release terms above

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.

Electronic Signature*