Geneva Baptist Church 2026 VBS Registration Form

Geneva Baptist Church 2026 VBS Registration Form
Registration Date

MonthDayYear
Date
Child's Information
Child's Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Gender
Grade Recently Completed
*Note: VBS registration is open for children aged 3 years old thru completed 6th grade.
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Any allergies or medical conditions?
Child's Pediatrician or Pediatrician's Office Name
Child's Insurance Company
Is there anything we should know about your child?
Please upload a recent photo of your child

Cancelof
Parent/Guardian Information
Parent/Guardian #1

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian #2

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Information
Emergency Contact #1

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact #2

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Other Information
Do you have a home church?
Does this child have any siblings attending VBS?
Enter sibling(s) names above
Other than parents/guardians or emergency contacts, is there anyone else who may pick up your child from VBS?

First NameLast Name
Would it be okay if we include photos and videos of your child on church social media or the church website?
Agreement
I, the undersigned, being the parent or legal guardian of the above named child, do hereby consent to the participation of my child in Vacation Bible School or other related activities at Geneva Baptist Church (GBC). I agree to indemnify and hold harmless GBC, its employees, agents and any other parties volunteering on behalf of the church from any and all actions, claims, liabilities, or damages of any kind as a result of my child’s participation in this event.

I hereby authorize GBC, its employees, agents and any other parties volunteering on behalf of the church to act on my behalf in authorizing medical care for my child in the event that I cannot be reached. I agree to be financially responsible for any and all treatment.
Parent/Guardian Signature
Date Signed

MonthDayYear
Date
Should be Empty:

Geneva Baptist Church 2026 VBS Registration Form

Child's Information

Parent/Guardian Information

Emergency Contact Information

Other Information

Agreement