Student Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Parent Name *

First Name

Last Name

Phone *

(###)

###

####

Emergency Contact Phone *

(###)

###

####

Permission for Medical Treatment *

I, the parent/guardian, hereby give my consent for my child to receive medical treatment deemed necessary by the staff or volunteers of Life Church's VBS in the event of an injury or illness during the program. I release Life Church and its staff from any liability for injury or illness occurring during my child's participation in the program.

I agree

Permission for Videos/Photos *

I grant permission for my child to be photographed or videotaped during Life Church's VBS activities. I understand that these images may be used for promotional purposes, including but not limited to social media, the church's website, newsletters, and other promotional materials. No personal information, such as names, will be disclosed in these materials.

I agree

No photos posted, please

Behavioral Agreement *

I understand that my child is expected to behave in a respectful and cooperative manner during Life Church's VBS. I agree to discuss appropriate behavior with my child and understand that inappropriate behavior may result in my child being sent home from the program.

I agree

Release of Liability *

I acknowledge that participation in Life Church's VBS involves physical activities that carry a risk of injury. I release Life Church, its staff, and volunteers from any and all liability for any injuries, damages, or losses my child may incur during their participation in the program.

I agree