Vacation Bible School
HOMETOWN NAZARETH REGISTRATION
For your child's safety, * indicates REQUIRED information.
Child's Last Name
*
First Name
*
Birthdate
*
*
Boy
Girl
Child's age as of June 22
*
Grade in school next fall
*
T-Shirt Size
*
Youth Extra Small
Youth Small
Youth Medium
Youth Large
Adult Small
Parent/Caregiver Last Name
*
First Name
*
Street Address:
*
City:
*
Zip Code:
*
Email address:
*
Phone:
*
Will you be attending as a family?
*
Yes
No
Emergency Contact if parent can't be reached
(Name, Relationship, Phone)
*
Known allergies or other medical concerns:
Please list or enter "none"
*
Would you like to help with VBS?
Yes, please contact me with volunteering information.
Do you have a home church?
Yes
No
If yes, name of your church:
Siblings also attending VBS:
Designated pick-up people:
*
Your family will be grouped together.
If your child attends without you, we will put them in a small group with a small group leader.
RELEASE: I hereby release and agree to hold harmless First Baptist Church of Champaign at Savoy (FBC-CS) and designated leaders from all liability for damage, illness, or injury. In case of emergency, I give my permission for any necessary medical treatment. I will not hold FBC-CS or any leader/staff persons responsible for any injury that may occur.
I also give my permission to FBC-CS to use photos/videos of my children, without any identification, in publications, worship services, and/or on their website for promotional purposes.
*
Yes, I Agree
*