Living Faith Missionary Baptist Church
Vacation Bible School Registration Form
Vacation Bible School is designed for 4 years old to students who have finished 8th grade. VBS will be held at Living Faith Missionary Baptist Church at 12515 AR-253, Fort Smith, AR 72916. My children will attend the following days:
Sunday, July 12th, 6pm - 8pm
Monday, July 13th, 6pm - 8pm
Tuesday, July 14th, 6pm - 8pm
Wednesday, July 15th 6pm - 8pm
Thursday, July 16th 6pm - 8pm
On July 16th after the last session of VBS we will have a VBS CELEBRATION from 8pm - 8:30pm which will include a short presentation and dessert! Please let us know how many TOTAL people from your family plan to attend:
Child's Name
*
First Name
Last Name
Last grade completed
*
2nd Child's Name
First Name
Last Name
Last grade completed
3rd Child's Name
First Name
Last Name
Last grade completed
Home Church (if any)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Information
*
First Name
Last Name
Relationship to child (mother, father, grandparent, etc.
*
Cell Number
*
Format: (000) 000-0000.
Email
example@example.com
Emergency Information
Please provide an emergency contact in case an emergency arises and you aren't available.
Emergency Contact's Name
*
First Name
Last Name
Relationship
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does your child(ren) have any allergies or medical needs we should be aware of?
*
Informed Consent and Acknowledgement
I hereby give my approval for my child's participation in any and all activities prepared by Living Faith Missionary Baptist Church. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Living Faith Missionary Baptist Church and all its respective officers, agents, and representatives from any and all liability.
Photo/Video Release
I grant Living Faith Missionary Baptist Church my permission to use the photographs/video of me or my child collected during VBS for any legal use, including but not limited to: publicity, advertising, and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
Confirmation
By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
By submitting this form, I ackowledge I have read and understand the above information.
Signature
Submit
Submit
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