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Register for VBS

  

Name: M  F    Age:      Date of Birth:
Address: City:   Zip:
Names of other Siblings attending VBS:                         Ages:   
Last Grade Completed:      
Special Requests (child to be put with sibling, friend, etc.): 
Attends what church:                Member:  Y   N    
    Guardian Information    
Parent/Guardian: Address:    Phone:
Person Responsible During VBS Week: Address:    Phone:
Emergency Contact: Address:    Phone:

Please fill out either Part I or Part II and sign.

  Part I               PERMISSION TO TRANSPORT CHILD

I give First United Methodist Church my permission to provide transportation for my child, , to the following Hospital or Clinic for emergency medical care or to  for emergency dental care, or to the nearest available source of assistance.

Parent's Name:    Date: 

 

Part II               REFUSAL TO GRANT PERMISSION

I do not give First United Methodist Church permission to transport my child, , for emergency medical or dental care.  In the event of an illness or injury which requires emergency medical or dental care, I wish the following action to be taken: 

Parent's Name:    Date: 

Photo/Video Release Form

I hereby give Marysville First United Methodist Church permission to take photographs/video of , or photographs/videos in which he/she may be involved with others for the purpose of promoting church activities.

This includes, but not limited to, items to be put on the church’s website, DVD’s, displays during services, and postal mailings.

I hereby release and discharge First United Methodist Church from any and all claims arising out of use of the photos/videos, or any rights that I or the minor may have.

I, am of full age, or am legal representative for the person in the above regard. I have read the foregoing document and fully understand its contents and know that I may revoke it at any time in writing.

This release expires one year from date of signature.

Signature:

Date:

Print name: