HILLCREST BAPTIST CHURCH VBS 2023

Hillcrest Baptist Church
Vacation Bible School

June 25-29
6:00-8:30 pm

Age 3 through Grade 12

CONTACT INFO@MYHILLCREST.ORG WITH QUESTIONS

Child's Name*

First NameLast Name

Age*

MonthDayYear

Gender*

Last Grade Completed*

Allergies, medical needs, security risk:*

Who is authorized to pick-up your child?*

Parent/Guardian's Names*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home Phone Number*

Area CodePhone Number

E-mail*

Cell Phone Number*

Area CodePhone Number

Emergency Contact Name*

First NameLast Name

Emergency Contact Relationship to Child*

Emergency Contact Telephone *

Area CodePhone Number

Are you a member or regular attender of Hillcrest Baptist?*

YesNo

If no, do you regularly attend a local church?*

YesNo

If Yes, where do you attend?*

Photographs are sometimes taken of children’s ministry activity for publicity and promotion purposes, which include, but are not limited to in-house presentations, church websites, brochures and newsletters. Children’s names or information are never used with specific permission.

Please check your preference below:*

I give Hillcrest Baptist Church permission to use my child’s image.I do not give Hillcrest Baptist Church permission to use my child’s image.

I, the undersigned parent or guardian, hereby consents to my child participating in VBS sponsored by Hillcrest Baptist Church. If my child has medical conditions which may be relevant to this program, I have listed them above. If I cannot be reached, I hereby authorize any adult connected with the program involved, including any physician and/or hospital, to implement any reasonable medical care, including surgery, deemed necessary for the welfare of my child. If there are any activities I do not want my child to participate, I have listed them above. I also release and agree to hold harmless Hillcrest Baptist Church as well as it’s members, and everyone else connected with the described program from any and all claims, cause of action, and the like, arising out of injury to my child, including death, which I or my child, or his/her heirs and assigns, may have in connection with the program involved. I have carefully read this document and understand its contents. Furthermore, the information that I have provided, as set forth hereon, it is accurate as far as I know. The within document shall be binding upon me, and upon my child’s heirs, beneficiaries.

By registering my child for this event, I agree to the terms and conditions listed above.*

YesNo

Name of Parent/Guardian completing form:*

Additional Comments