Vacation Bible School Registration Form

Vacation Bible School Registration Form

"Jesus My Trailblazer" 2026
Thanks for registering your child(ren) to this year’s Vacation Bible School “Jesus my Trailblazer” conducted by the Madoc Seventh-day Adventist Church at 46 Cooper Rd Madoc, Ontario.

We are excited to conduct this VBS on the grounds of our church under a tent. We look forward in meeting you and your children soon. God bless you and your family and keep you safe and healthy. - VBS Team
How many children will you be registering? (max 7)
1 - Full Name

First NameLast Name
1 - Age
1 - Birthday

YearMonthDay
Date
Please choose a T-Shirt Size for {name} :
2 - Full Name

First NameLast Name
2 - Age
2 - Birthday

YearMonthDay
Date
Please choose a T-Shirt Size for {2} :
3 - Full Name

First NameLast Name
3 - Age
3 - Birthday

YearMonthDay
Date
Please choose a T-Shirt Size for {3} :
4 - Full Name

First NameLast Name
4 - Age
4 - Birthday

YearMonthDay
Date
Please choose a T-Shirt Size for {4} :
5 - Full Name

First NameLast Name
5 - Age
5 - Birthday

YearMonthDay
Date
Please choose a T-Shirt Size for {5} :
6 - Full Name

First NameLast Name
6 - Age
6 - Birthday

YearMonthDay
Date
Please choose a T-Shirt Size for {6} :
7 - Full Name

First NameLast Name
7 - Age
7 - Birthday

YearMonthDay
Date
Please choose a T-Shirt Size for {7} :

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Parent/Guardian:

First NameLast Name
Mobile Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Email:
example@example.com
Allergies, Special Needs
Attendance:

Media Release Form

Date of Vacation Bible School: July 7-10, 2026

Location of Vacation Bible School: 46 Cooper Rd, Madoc, ON K0K 2K0

Names(s) of Child(ren): {name}, {name2}, {name3}, {name4}, {name5}, {name6}, {name7}

Name of Parent(s)/Guardian(s): {nameOf}

Consent and Release

I hereby grant permission to the Jesus My Trailblazer Vacation Bible School Program
to use photographs and/or video recordings of me or my child(ren) taken during this Vacation Bible School, held on the dates and at the location listed above.

These materials may be used in various publications, public affairs releases, recruitment materials, broadcast public service announcements, or for other similar lawful purposes.

I understand and agree that these materials will become the property of Jesus My Trailblazer Vacation Bible School Program and will not be returned.

I hereby authorize Jesus My Trailblazer Vacation Bible School Program
to edit, alter, copy, exhibit, publish, or distribute these materials for any lawful purpose. I waive any right to inspect or approve the finished product in which my or my child(ren)’s likeness appears. I further waive any right to royalties or other compensation arising from or related to the use of the photographs or recordings.

Release of Claims

I hereby release, hold harmless, and forever discharge Jesus My Trailblazer Vacation Bible School Program from any and all claims, demands, or causes of action that I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate may have as a result of this authorization.
Signature

Medical Release Form

Names(s) of Child(ren): {name}, {name2}, {name3}, {name4}, {name5}, {name6}, {name7}

Name of Parent(s)/Guardian(s): {nameOf}

Parental Consent, Release, and Emergency Authorization

I/We, the undersigned, are the parent(s) or legal guardian(s) of the above-named child(ren). By enrolling my/our child(ren) in the child care services provided by Jesus My Trailblazer, I/we agree to release and hold harmless Jesus My Trailblazer, it's directors, officers, employees, and consultants from any and all claims, demands actions, suits, costs, or charges arising out of or in connection with the provision of these child care services, including but not limited to bodily injury to my/our child(ren), excpet in cases of gross negligence or intentional misconduct by Jesus My Trailblazer.

I/We hereby grant permission to Jesus My Trailblazer and its personel to take any actions they deem reasonably neceesary regarding my/our child's health and safety in the event that I/we cannot be reached, or when time is of the essence. I/we fully release Jesus My Trailblazer and its personnel from any liability related to such decisions.

I/We grant permission for emergency treatment for my/our child(ren) by a rescue squad, private physician, hospital, or emergency health care facility staff, if needed. I/We acknowledget that Jesus My Trailblazer will act in the best interest of my/our child(ren) and will notify me/us of any such action as soon as reasonably possible.
Signature
Should be Empty:

Vacation Bible School Registration Form

Media Release Form

Consent and Release

Release of Claims

Medical Release Form

Parental Consent, Release, and Emergency Authorization