2026 VBS REGISTRATION FORM

2026 VBS REGISTRATION FORM
CHILD

First NameLast Name
GRADE IN 2026-2027 SCHOOL YEAR
DATE OF BIRTH

MonthDayYear
Date
Please provide any medical condition that we need to be made aware of regarding your child; including food allergies and prescription medication(s) taken by your child.
LEAVE BLANK IF "NONE"
LEGAL PARENT OR LEGAL GUARDIAN

First NameLast Name
ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PHONE NUMBER
Please enter a valid phone number.Format: (000) 000-0000.
ALTERNATIVE NUMBER
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
Parent's OR Legal Guardian's Email
EMERGENCY CONTACT (FULL NAME)
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
EMERGENCY INFORMATION AND MEDICAL AUTHORIZATION

In the event that I the parent(s), legal guardian(s) or emergency contact person cannot be reached. I authorize Saltgrass Cowboy Church VBS Volunteers and/or their agents to seek the necessary medical treatment for my child in the event of an injury during VBS scheduled indoor and outdoor activities during the week of VBS. I understand that all effort will be made to contact the Emergency Contact Person or myself immediately in the event of a medical emergency involving my child. I authorize Saltgrass Cowboy Church volunteers and/or its agents to call 911 immediately if necessary.
INITIALS
FAMILY PHYSICIAN'S NAME
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
PREFERRED HOSPITAL NAME
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

2026 VBS CONSCENT FORM
PARENTS PLEASE READ AND INITIAL

ACTIVITIES PARTICIPATION
The undersigned does hereby give permission for my child to attend and participate in all Saltgrass Cowboy Church activities throughout VBS week, Monday, July 13, 2026 - Thursday, July 16, 2026, including VBS outdoor games, bounce houses and obstacle-course activities which include several inflatable bounce houses and cooling stations. I, the undersigned, do hereby release, discharge and agree to hold harmless Saltgrass Cowboy Church, its Pastors, Directors, Employees, Volunteers and Teachers (collectively herein the "Church") from any and all liability, claims or demands for accidental personal injury, sickness or death, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the children/youth 2026 VBS activities, contact with animals or livestock that are part of the event.
INITIALS
WAIVER LIABILITY RELEASE
In consideration of Saltgrass Cowboy Church allowing the above child(ren) to participate in Vacation Bible School activities, we (I), the undersigned, do hereby release, forever discharge and agree to hold harmless Saltgrass Cowboy Church, its Directors Employees, Volunteers, and Agents (collectively herein the "Church" from any and all liability, claims or demands for accidental personal injury - sickness or death as well as property damage and expenses, of any nature whatever which may be incurred by the undersigned and the above child involved in daily Vacation Bible School activities. Parent's signature(s) indicate agreement with the Parental Consent and Liability Release on this document. Furthermore, in case of injury to my child, I hereby waive all claims against Saltgrass Cowboy Church, including all volunteers, staff officers, agents, and representatives. There is a is always possible risk of being injured that is inherent in all indoor and outdoor activities.
INITIALS
PHOTO/PICTURE/VIDEO AUTHORIZATION
I (we) give my (our) consent to Saltgrass Cowboy Church to use take and use photo or video images taken of my (our) child(ren) solely for the use of church brochures, advertisements for the church, on the church website, in the church social media and in other church publications specifically for their 2026 Vacation Bible School. I (we) agree to hold harmless Saltgrass Cowboy Church from any liability which may result from the use of said picture(s). This form will apply through my (our) child(ren) tenure at Saltgrass Cowboy Church daily during 2026 Vacation Bible School.
INITIALS
Date

MonthDayYear
Date Signed
Signature
Should be Empty: