Magnified | VBS 2025

Parent/Guardian Information
Name 1

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
This is a fill in the blanks field. Please add appropriate blank fields and text.
Relationship
Name 2

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Home Church Name
Authorized person who can pickup the child on dismissal

First NameLast Name

Agreement
1. I allow my child to participate in this program or bible study during vacation time.
2. I authorize the school, bible study conductor, volunteer personnel to conduct first aid, and medical care in the event of an emergency situation. I agreed to pay for all the medical care expenses and costs in a given situation that medical care is needed.
3. I confirm that all information in this form is accurate and true to the best of my knowledge.
YesNo
Parent/Guardian Signature

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Date Signed

MonthDayYear
Date
Should be Empty:

VBS| Magnified | June 2nd - 6th, 2025