Open to children Age 4 to 8th Grade

Child's First Name (required)

Child's Last Name (required)

School Grade just completed (required)

Age (required)


Parent or Guardian(s) Name(s) (required)

Your Relationship to the child (parent, grandparent, aunt/uncle, etc.)(required)

Your Email Address (required)

Phone Number (required)

Can this number accept text messages? (required)
 yes no

Address (required)

City, State, Zip (required)

Home Church

Emergency Contact Name (other than Parent/Guardian) (required)

Emergency Contact Phone Number (required)

Any Medical or Other special information we need to know
(allergies, etc.)

Who else may pick up your child from VBS?
Other than parent/guardian
(First and Last name, please)

MEDICAL RELEASE:
I give my permission for the VBS staff to administer basic first aid to my child(ren) (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.

PHOTO RELEASE:
I hereby grant the above named church permission to copyright and use photographs/videos taken at VBS of the minor(s) designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.

PERMISSION TO ATTEND:
I give permission for my child(ren) (named above) to attend the Vacation Bible School (VBS) listed above at Sparta First Baptist Church.


 By selecting this box, I grant permission and agree to the above statements.