Union Branch Baptist Church VBS Registration 2025
July 17–19 | (5:45pm Dinner) 6:00 PM – 8:30 PM | Sat. 12pm
Name
First Name
Last Name
Age (Youth Only)
Gender
Class Selection
Nursery & Preschool (Birth – 5 yrs)
Children (6 – 11 yrs)
Pre-Teens (12 – 14 yrs)
Teens (15 – 17 yrs)
Young Adults (18 – 35 yrs)
Midway Adults (36 – 50 yrs)
Adults (50+)
Home Number
Please enter a valid phone number.
Format: (000) 000-0000.
Does the child have any allergies? If yes, please list them below: (YOUTH ONLY)
Does the child currently medications? If yes, please list them below and provide the reason:(YOUTH ONLY)
Does the participant have any medical condition that we should be aware of? If yes, please explain below:
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Parent / Guardian Information
Name
First Name
Last Name
Relationship to Child
Telephone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Terms and Conditions
I allow my child to participate in this program.
I hereby authorize the church, bible study conductor, volunteer personnel to conduct first aid, and medical care in the event of an emergency situation. I agree to pay for all the medical care expenses and costs in a given situation that medical care is needed.
I release the organizers from any liabilities that might happen during the activity and hold them harmless in the event of damages, injuries, or accidents.
I confirm that all information in this form is accurate and true to the best of my knowledge.
Parent/Guardian Signature
Date Signed
-
Month
-
Day
Year
Date
Submit
Should be Empty: