VBS REGISTRATION

June 25 - 29

8:45 am - 12 pm

Child's Name *
Child's Name
Date of Birth
Date of Birth
Address *
Address
Phone *
Phone
Photo Release *
I hereby: grant permission to Ocean View Baptist Church to use pictures of my child on their website for informational or promotional purposes. By checking the designated box I acknowledge this to be an original signature. This will be used for recap slideshows featuring the kids each day!
Medical Information
Emergency Contact *
Emergency Contact
Emergency Contact Number *
Emergency Contact Number
Insurance
Medical Release *
I(we), the parent(s) or guardian(s) of the above said child, a minor, do hereby authorize adult volunteers of Ocean View Baptist Church as agent(s) for the undersigned, to consent to any medical or surgical care deemed advisable by any accredited physician or surgeon in an approved emergency clinic or hospital. I further release from any liability Ocean View Baptist Church, and any of its ministries or leaders in the event of an accident en route, during and returning from the above mentioned event. This agreement does not apply to claims for intentional misconduct or gross negligence. By checking the designated box you acknowledge this to be an original signature:
Pick Up Permission
Pick Up Permission *
By checking the box below I give an additional adult(s) permission to pick up my child from Ocean View Baptist Church. By checking this box I acknowledge it as a signature of permission.
Names of adult(s) allowed to pick up my child besides parent/guardian listed.