Catoctin Bible Church

VBS Registration Form

Please fill out your details to register.
Participant's Full Name*

First NameLast Name
Participant's Age*
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address*
example@example.com
Emergency Contact Name*

First NameLast Name
Relationship to Child*
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Allergies or Medical Conditions
Photo/Video Permission

Yes, I allow photosNo, please do not include my child
Pickup Authorization

Enter the details of the person authorized to pick up the child.
Authorized Person's Full Name*

First NameLast Name
Authorized Person's Full Name*

First NameLast Name
Relationship to Child*
Medical Release + Liability Waiver
I, the undersigned parent/guardian, give permission for my child to participate in Vacation Bible School activities at Catoctin Bible Church. In the event of illness or injury, I authorize church staff and volunteers to obtain medical treatment for my child as deemed necessary. I understand that reasonable efforts will be made to contact me in case of an emergency.

I acknowledge that participation in activities involves some risk, and I release and hold harmless Catoctin Bible Church, its staff, and volunteers from liability for injuries or damages, except in cases of gross negligence. I certify that the medical information provided is accurate to the best of my knowledge.
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Signature*
Date*

MonthDayYear
Date
Should be Empty:

VBS Registration Form

Pickup Authorization

Medical Release + Liability Waiver