Goucher VBS Registration
Welcome to Goucher Baptist Church! We are so excited that you will be joining us this year! Please complete the form below to register your student. We can’t wait to see everyone at the Illumination Station!
Student Information
Each student attending VBS will need to be registered separately from any siblings.
Name
*
First Name
Last Name
Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
Male
Female
Grade completed
*
Please Select
Preschool
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Siblings enrolled in VBS
*
Guardian Information
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Email
*
Relationship to child
*
Emergency Contacts
Please list the first and last names as well as the phone number of two other adults (different from the guardian listed above) who are allowed to pick up the child. The child will only be released to these people.
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Relationship to child
*
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Relationship to child
*
Medical Information
Please list any allergies or list “none” if there are none.
*
Does your child carry an epi-pen?
*
Please Select
Yes
No
Please list any medical concerns or type “none” if there are none.
*
VBS photos/videos are taken for promotional purposes related to Goucher Baptist Church and Vacation Bible School. These pictures may appear in various media outlets such as our website, facebook page, instagram, etc. Do you allow your child to be included in these photos/videos?
*
Yes
No
RELEASE OF LIABILITY WAIVER - By signing this form, I give permission for my child to participate in Vacation Bible School 2026: Illumination Station at Goucher Baptist Church, held May 31–June 3, 2026. I understand that participation in VBS activities may involve normal risks, including the possibility of injury. I knowingly and willingly accept these risks for my child. I agree to release and hold harmless Goucher Baptist Church, along with its staff, clergy, volunteers, and any others helping with VBS, from responsibility for injuries, accidents, or property damage that may occur while my child is participating in VBS activities, even if caused by ordinary negligence. By signing below, I confirm that I have read and understand this agreement and give permission for my child to participate in VBS 2026: Illumination Station at Goucher Baptist Church.
*
I agree
EMERGENCY POLICY ACKNOWLEDGEMENT - I understand that every effort will be made to contact me if there is an emergency involving my child. If I cannot be reached and immediate medical care is needed, I give permission to Goucher Baptist Church leadership to seek medical treatment for my child. This includes emergency care, hospitalization, anesthesia, surgery, medication, and transportation if necessary. I authorize medical professionals to provide any treatment they believe is in my child’s best interest. I understand that I am responsible for any medical costs related to this care.
*
I agree
I am the legal parent or guardian of the participant named in this form. By providing my electronic signature, I confirm that I have read, understand, and agree to the Release of Liability Waiver, Emergency Policy Acknowledgement, and the selections I made in the Photo Release Authorization. I understand that my electronic signature is legally binding and has the same effect as a handwritten signature.
*
Submit
Submit
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