VBS Children's General Registration | Redeemer Covenant Church

If you wish to enroll your child(ren) in our VBS program, please submit the form below. Please note, some of our activities involve water/getting wet. Have your child dress appropriately and let us know if this is an issue in the appropriate field below. Thank you!

PRINTABLE CHILD(REN) REGISTRATION FORM

CHILD(REN) REGISTRATION FORM

Parent/Guardian First Name

Parent/Guardian Last Name

Address

Primary Phone

Emergeny Contact

Home church

Children's NAMES, AGES and T-SHIRT SIZE (Youth S, M, L, XL)

Food allergies/sensitivites; medical or special needs/instructions?

Others permitted to pick up your child from VBS

Upon submission, I hereby give permission for above children to attend and participate in Redeemer Covenant Church’s (RCC) Vacation Bible School (VBS), June 26-30, 2023.

PHOTO PERMISSION: I give my consent to RCC to use photo or video images taken of my child(ren) in church brochures, advertisements for the church, on the website, in social media, and in other church publications as they see fit. I agree to hold harmless RCC from any liability which may result from the use of said picture(s). None of the photos to be taken will be for personal use.

LIABILITY RELEASE: In consideration of RCC allowing the above child(ren) to participate in VBS activities, I do hereby release, forever discharge and agree to hold harmless RCC, its directors, employees, volunteers and agents (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by my child(ren) while involved in VBS. Furthermore, I hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in activities involved therein. As well as releasing the child(ren) if necessary for transportation to and from the VBS location. I do hereby release, forever discharge and agree to hold harmless RCC, directors, employees, volunteers and agents from any and all liability, claims or demands for accidental personal injury in the process of transportation.

MEDICAL TREATMENT PERMISSION: I authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child(ren) to this authorization.

Thanks for submitting!