VBS Waiver Form

VBS Waiver Form

Please fill out this form to complete the VBS waiver.
Participant Name

First NameLast Name
Parent/Guardian Name

First NameLast Name
Participant Age
Parent/Guardian Email
example@example.com
Parent/Guardian Phone
Please enter a valid phone number.
Emergency Contact Name

First NameLast Name
Emergency Contact Phone
Please enter a valid phone number.
Please list any allergies or medical conditions
I consent to my child's participation in the VBS program.

YesNo
I authorize the VBS staff to seek emergency medical treatment for my child if necessary.

YesNo
Photo Permission

I First Name Last Name , give Wellspring United Methodist Church permission to take photos of First Name Last Name to be used on the church website,
Facebook, and as part of a Vacation Bible School worship slide in Sunday Service.
By signing this form, I agree to release and hold harmless the VBS program, staff, and volunteers from any claims or liability arising from my child's participation.

Powered by Jotform SignClear
Should be Empty: