FAMILY PAGE for Vineville Baptist Church Annual Permission Slip

General VBC Preschool/Children/Youth Permission Slip FAMILY PAGE
This is the family information page to accompany the minor information pages that serve as an annual permission form for your child(ren) to participate in preschool, children's, and youth activities from August 2026-August 2027. Additional forms for specific activities may also be necessary as the year goes on.
Please list all minors covered by this form and submit a "Minor's Information" page for each:
Child #1 Name - You will be expected to submit a "Minor's Information" page for this child.
Child #2 Name - You will be expected to submit a "Minor's Information" page for this child.
Child #3 Name - You will be expected to submit a "Minor's Information" page for this child.
Child #4 Name - You will be expected to submit a "Minor's Information" page for this child.
Child #5 Name - You will be expected to submit a "Minor's Information" page for this child.
Child #6 Name - You will be expected to submit a "Minor's Information" page for this child.
Parent/Guardian #1
Name:
Relationship to Minors listed:
Phone Number(s):
Format: (000) 000-0000.
this should be a number where you can be reached while your child(ren) is involved in an activity with Vineville Baptist Church.
Email Address:
ornek@ornek.com
Mailing Address:
Parent/Guardian #2
Name:
Relationship to Minors listed:
Phone Number(s):
Format: (000) 000-0000.
this should be a number where you can be reached while your child(ren) is involved in an activity with Vineville Baptist Church.
Email Address:
ornek@ornek.com
Mailing Address:

Alternative Emergency Contact #1
Name:
Relationship to Minors listed:
Phone Number(s):
Format: (000) 000-0000.
this should be a number where they can be reached while your child(ren) is involved in an activity with Vineville Baptist Church.
Alternative Emergency Contact #2
Name:
Relationship to Minors listed:
Phone Number(s):
Format: (000) 000-0000.
this should be a number where they can be reached while your child(ren) is involved in an activity with Vineville Baptist Church.
General Liability Release: In consideration of Vineville Baptist Church allowing the minors listed above to participate in activities of various kinds, I, the undersigned parent/guardian, do hereby release, forever discharge, and agree to hold harmless Vineville Baptist Church, its ministers, employees, and volunteers 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 whatsoever may be incurred by the undersigned and the participants while involved in a Vineville Baptist Church sponsored activity.
Please affirm your agreement by typing your name and date in the space below.
Type your name here.
Type today's date here: mm/dd/yyyy
I, the undersigned parent/guardian, understand that I, or a designated adult for whom I will provide contact information, need to be accessible by phone while my children are participating in activities with Vineville Baptist Church. I also understand that unless otherwise stated, I, or a designated adult for whom I will provide contact information, am expected to remain on campus while my children are participating in activities with Vineville Baptist Church.
Please affirm your agreement by typing your name and date in the space below.
Type your name here.
Type today's date here: mm/dd/yyyy
General Photo Release: I, the undersigned parent/guardian, grant permission to Vineville BaptistChurch to take and use photographs or video of my child for use in church-related publications,newsletters, VBC websites or other electronic forms of media, without prior notification.
Please affirm or deny your agreement and type your name and date in the space below.
Type your name here.
Type today's date here: mm/dd/yyyy
Should be Empty:

Parent/Guardian #1

Parent/Guardian #2

Alternative Emergency Contact #1

Alternative Emergency Contact #2

General Photo Release: I, the undersigned parent/guardian, grant permission to Vineville BaptistChurch to take and use photographs or video of my child for use in church-related publications,newsletters, VBC websites or other electronic forms of media, without prior notification.