2026 Temple Baptist VBS Registration

Child 1 Name

Medications, Allergies, or Medical Conditions

Gender

Age

Birthdate

Date

Last Grade Completed

Child 2 Name

Medications, Allergies, or Medical Conditions

Gender

Age

Last Grade Completed

Child 3 Name

Medications, Allergies, or Medical Conditions

Gender

Age

Birthdate

Date

Last Grade Completed

Child 4 Name

Medications, Allergies, or Medical Conditions

Gender

Age

Birthdate

Date

Last Grade Completed

Mother's Name

Custodial Parent: Yes or No

Mother's Cell

Mother's Address

Father's Name

Custodial Parent: Yes or No

Father's Cell

Father's Address

Emergency Contact Info

Name of People Authorized to Pick up Child(ren)

Parents/ Guardians: Please read the releases below and sign at the bottom.

General: I give my consent for my child(ren) to attend meetings, activities, and events, both on site and off site. I will be provided specific event information in advance of any activity that will be taking place offsite.

Medical: In the event of a medical emergency and when a contact cannot be made in a timely manner to me and/or the emergency contact listed, I give permission for my child(ren) to receive appropriate medical attention. In the event of an unforeseen emergency or any accidents, I release Temple Baptist Church, its employees, and volunteers, and all those related to it, from any liability. I have provided emergency contact numbers and am assured that I will be contacted as soon as possible in the event that there is an emergency.

Photograph release: Occasionally photos and videos may be taken during VBS, Sunday School, worship, youth group events, or other church activities. I grant permission for Temple Baptist Church to post photos videos including my child(ren) on its website or in other church publications. I agree with the above releases.

Parent/Guardian Signature

Parent/Guardian Printed Name

Date