CHILD REGISTRATION FORM
Child's Full Name:
*
Gender:
*
M
F
Age:
*
Last school grade completed:
*
Person picking up Child:
*
Phone #:
*
Format: (000) 000-0000.
Email Address:
*
example@example.com
Home Church:
Allergies, Medical conditions, or special needs:
In case of emergency contact:
*
Phone #:
*
Format: (000) 000-0000.
Relationship to Child:
*
Parent/Guardian Signature:
*
PHOTO & SOCIAL MEDIA RELEASE
I, ________________________________ give permission for my child to be photographed or videotaped during VBS activities for any use, including but not limited to: publicity, copyright purposes, illustration, advertising. I understand that Lighthouse Church has various social media accounts. This is a space for the staff to share student photos and videos of their daily activities, classroom functions, awesome work, special events, field trips, and other school functions. Furthermore, I understand no royalty, fee or other compensation shall become payable to me by reason of such use.
I DO give permission
I DO NOT give permission
Student's Name:
Parent/Guardian's Name:
Parent/Guardian's Signature:
Date:
-
Month
-
Day
Year
Date
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Should be Empty: