Clone of FBCIL VBS 2025 Registration

DUDE NO ONES PERFECT 2026 VACATION BIBLE SCHOOL REGISTRATION

JUNE 3-5TH | 6-8:30PM | PK-5TH
Child's Name:*

First NameLast Name
Birth Date:*

MonthDayYear
Age:*
Grade Completed:*
Parent/Gardian:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone:*

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:*
Emergency Contact:*

First NameLast Name
Emergency Contact Phone:*

Area CodePhone Number
Who is Picking up Child:
Special Needs / Alergies / Concerns:
**Please note: There will be loud music and possibly flashing lights. If your child is sensitive to these types of environments, please make arrangements for them to feel comfortable. If your child has episodes due to flashing lights, please note that in the special needs box. **
Please provide your consent below*

I give permission to my child/children to attend DUDE NO ONES PERFECT Vacation Bible School [VBS] at First Baptist Church of Imperial Lakes, 1905 Shepherd Rd. Lakeland, FL 33811, on June 3rd-5th 2026. This consent form gives permission to seek whatever medical attention is deemed necessary, and releases First Baptist Church of Imperial Lakes and its staff of any liability against personal losses of named child/children.I/We the undersigned have legal custody of the student(s) named below, a minor(s),and give our consent for him/her to attend events being organized by First Baptist Church of Imperial Lakes. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/We hereby release First Baptist Church of Imperial Lakes, its pastors, employees, agents and volunteer workers from any and all liability for any injury, loss or damage to person or property that may occur during the course of my/our child’s involvement. In the event that he/she is injured and requires the attention of a doctor, I/We consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by First Baptist Church of Imperial Lakes, I/We agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/We affirm that the information provided on First Baptist Church of Imperial Lakes Vacation Bible School registration form is accurate at this date for the student(s)named below. I/We also agree to bring my/our child/children home at my/our expense should they become ill or if deemed necessary by the Children’s Ministries Staff Member.I/We release First Baptist Church of Imperial Lakes to utilize pictures or videos taken for the following purposes of printed materials to include brochures and bulletins, web site, video, slide or PowerPoint usage.
Signature*
Should be Empty:

DUDE NO ONES PERFECT 2026 VACATION BIBLE SCHOOL REGISTRATION