2025 VBS Registration

Participant's Information

Name*

First NameLast Name

Last Grade Completed*

Birth Date*

MonthDayYear

Gender*

MaleFemale

Parent/Guardian Information

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Does your child have any allergies, including food allergies, chronic illness, or medical conditions? If yes, please describe. *

Does your child have any conditions that may affect their ability to fully participate, or that we should otherwise be aware of (asthma, learning disabilities, etc)? If yes, please describe. **

I authorize Hope Bible Church and its agents to use media of my child from VBS, including pictures, video, audio recording, and other media, without further consent or notification. This use includes but is not limited to promotion of HBC, its children’s ministry, and other ministries in print, social media, its website, and other media.

YesNo

I understand that I will be notified in the case of a medical emergency. However, I understand that if I cannot be reached, I authorize church leadership to seek medical services and treatments for my child. I release Hope Bible Church, its staff, and its volunteers from liability and its representatives will not be responsible for medical expesnses incurred on the basis of this authorization. *

YesNo, we will not be participating

VBS 2025 Hope Bible Church