Vacation Bible School Registration 2024

Parent's Name

Parent's Email

This address will receive a confirmation email

Phone

Address

Participant's Info

If registering more than 3 children (from your family), please open a new Registration Form after filling this one out.

Child #1 Name

Child #1 Birthdate

Child #1 Grade just finished

Kindergarten Grad 1st Grade Grad 2nd Grade Grad 3rd Grade Grad 4th Grade Grad 5th Grade Grad 6th Grade Grad

Child #2 Name - If not needed, jump down to Emergency Info

Child #2 Birthdate

Child #2 Grade just finished Kindergarten Grad 1st Grade Grad` 2nd Grade Grad 3rd Grade Grad 4th Grade Grad 5th Grade Grad 6th Grade Grad

Child #3 Name - If not needed, jump down to Emergency Info. If more children in family, please finish this one & then start a new form

Child #3 Birthdate

Child #3 - Grade finished Kindergarten Grad 1st Grade Grad 2nd Grade Grad 3rd Grade Grad 4th Grade Grad 5th Grade Grad 6th Grade Grad

Emergency Info

Medical Notes for any of these registered children? If nothing to list, type in "No." If there's something we should know, please list with their name. Ex. Fred - Allergic to pizza.

Is sponsor authorized to approve medical treatment?

Yes No

Are participants covered by personal/family medical insurance? If yes, please give name of Insurer & policy number if needed

Emergency Contact's Name & Phone Number

VBS Participation Agreement

In consideration for the opportunity to participate in the VBS described above (the "activity"), your checkmark on this box indicates that the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/ guardian) accepts personal financial responsibility for any injury/loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, any other representatives (collectively referred to as the “activity sponsor”). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise.
I also give my consent to Royal Palms Baptist Church to photograph, film and then use, reproduce & publish said images of me &/or my child/children.I agree that these images are the property of Royal Palms Baptist Church, with full right of disposition in any manner whatsoever. I release Royal Palms Baptist Church & his/her legal representatives and assigns from any & all claims whatsoever in connection with the use of said images.

By checking this box, I am signifying that the parents/guardians of the above named participants agree with each statement in this VBS Participation Agreement.

Yes, I agree.

Dinner Options

As a help to you & your family, we are offering inexpensive & very Kid Friendly meals at 4:45pm each day. If you would like to take advantage of these there are several options to choose from:
* $2 cost per person, per day you want to eat.
* Meal Ticket package: 5 individual meal tickets for $9
* Plan to eat, but pay at the door
Just add up what you plan to use & pay for the amount you think you will need. Remember, you can pay at the door if you prefer, just let us know you are planning to join us.

We plan to eat dinner at VBS.

Yes No Not sure

How many $2 meal tickets would you like to purchase today?

How many Meal packages do you want to purchase?

Optional Meal Payment $

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Vacation Bible School Registration 2024

Description

Please Fix the Following