Bethany-Zoar Vacation Bible School Registration
  • Bethany/Zoar UMC Vacation Bible School Registration

    June 10th-14th, 2019, from 6PM-8PM
  • Child's Information

  • Parent/Guardian Information

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  • Emergency Information

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  • Medical Release and Authorization

     

    My child has my permission to attend and particpate in Bethany-Zoar UMC's events through December 31, 2019. I understand some of the activities in which my child shall particpate will require physical exertion and the cooperation of my child. I will not hold Bethany-Zoar United Methodist Church, any of its staff, chaperones or volunteers, responsible in the event of an accident or injury. In the event of serious illness or accident, efforts will be detrimental to the health of the patient, I hereby grant the staff of Bethany-Zoar United Methodist Church, and its counselors, the authority to consult with, seek treatment from, and/or surgery by the attending physician or dentist.

    With complete undrestand of the above, permission is hereby granted to the consulted physician or dentist to permor essential, routine or emergency dental, medical or surgical treatment during the period my child is a participat in Bethany-Zoar United Methodist youth or children's events through December 31, 2019. I further undrstand that I will be responsible for all medical, dental or surgical expenses incurred by the necessity of hospitalization or treatment by the consulting doctors. 

    I will not hold Bethany-Zoar United Methodist Church, any of its staff, nor activity leaders, responsible in the event of an accident or injury. I release Bethany-Zoar United Methodist Church and its agents from any and all claims, demands, cause of actions, past, present, or future arising out of any dmage or injury while participating in the church's activities. 

  • 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.

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