VBS Registration Form 2026

VBS Registration Form 2026

Complete the registration using the provided PDF structure. Please fill in all required sections accurately.
Child Information
Child 1 name
Child 1 sex
Child 1 grade
Child 1 date of birth

MonthDayYear
Date
Health conditions affecting the child
Allergies or food restrictions
Child 2 name
Child 2 sex
Child 2 grade
Child 2 date of birth

MonthDayYear
Date
Child 3 name
Child 3 sex
Child 3 grade
Child 3 date of birth

MonthDayYear
Date
Parent / Guardian Information
Parent / Guardian Name
Parent / Guardian Address Line 1

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent / Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent / Guardian Alternate Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent / Guardian Email
example@example.com
Emergency Contacts
Emergency contact 1 name

First NameMiddle NameLast Name
Emergency contact 1 relationship
Emergency contact 2 name

First NameMiddle NameLast Name
Emergency contact 2 relationship
Medical, Permissions, and Consent
· I acknowledge that normal summer FBYouth/FBKids activities including but not limited to swimming, zip lining, volunteer work projects, hiking, and games of all types at First Baptist or Moses Merrill Camp & Conference Center may result in various types of injury including, but not limited to sickness, exposure to infectious/communicable disease, bodily injury, emotional injury, personal injury, property damage and financial damage.

· In consideration for the opportunity to participate in summer camp and all activities, I, the parent /guardian of this minor child acknowledges and accepts the risk of injury associated with participation in summer camp and all activities. I accept personal financial responsibility for any injury or other loss sustained while at First Baptist or Moses Merrill Camp & Conference Center. Further, I, the parent/guardian release and promise to indemnify, defend, and hold harmless First Baptist or Moses Merrill Camp & Conference Center for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise.
I give permission for FBC or Camp to administer medications as it deems necessary to my child. This includes medication sent with my child, or nonprescription medication availabe at camp.
In case of emergency, I understand every effort will be made to contact me. In the unlikely event I cannot be reached, I give permission to the physician selected by the FBC or Camp to hospitalize and secure proper treatment (including emergency surgery) for my child.
I give permission for any photos taken during camp to be used for FBC or Camp Publicity and used on our social media.
I give permission for FBC and Camp Moses Merrill to Transport my child off camp property for planned activities.
Parent / Guardian Name for Consent
Signature
Parent Signature
Date

MonthDayYear
Date
Should be Empty:

VBS Registration Form 2026

Child Information

Parent / Guardian Information

Emergency Contacts

Medical, Permissions, and Consent

Signature