VBS Pre-Registration

Welcome to PRE-REGISTRATION!

We are thrilled that you are planning to join us! See you at the farm!

Please complete the following registration form so you won't have to when you arrive! We look forward to seeing you in July!

- 2019 VBS Team of West Race

Check-In Each Night: 5:45PM

Info For Child Or Teen

* Indicates required field

Name *

First

Last

Invited By *

Grade Completed *

Age *

Birthdate (mm/dd/yyyy) *

How many people in your family will be attending? *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Allergies / Health Conditions / Medications *

Parent / Guardian Info

Name *

First

Last

Phone Number *

Email *

Emergency Contact Info

Please provide the name and phone number of someone other than the child's parent or guardian.

Name *

First

Last

Phone Number *

Church Info

Do you have a church home? *

If so, what is the name of your church? *

If not, how may we contact you? *

Call Text Mail Email

Photography / Video Authorization

I acknowledge that any child registered on this form, as a participant in Vacation Bible School at West Race Baptist Church, may be photographed or captured on video during the Vacation Bible School program and activities. I hereby grant full permission to West Race Baptist Church to use photographs or videos-in print, electronic, online, or other public media-of the child registered on this form and further release West Race Baptist Church from any and all liability connected with the authorized use of words and image of the child registered on this form.

Check below if you read the above and agree. *

I agree to the Photography / Video Authorization. I do not agree to the Photography / Video Authorization.

Liability Release

In the event of an emergency, I understand that all will be done to contact me or the emergency contact named above. However, if neither can be reached, I give full permission to a representative of West Race Baptist Church to seek medical attention in my absence for the child registered on this form. I also hereby assume all risk, known or unknown, for the child registered on this form, in connection with their attendance and participation in Vacation Bible School at West Race Baptist Church. I acknowledge that participation in Vacation Bible School at West Race Baptist Church is voluntary and therefore I FULLY RELEASE and discharge West Race Baptist Church, its pastor, employees, directors, and volunteer workers, from any and all liability in connection with any activities carried on at West Race Baptist Church in the Vacation Bible School program.

Check below if you read the above and agree. *

I agree to the above Liability Release.

Feedback

How did you hear about our VBS? *

Questions / Comments *

Upon submission of the above information, please wait for a confirmation screen.

Submit

Welcome to PRE-REGISTRATION!

Info For Child Or Teen

Parent / Guardian Info

Emergency Contact Info

Church Info

Photography / Video Authorization

Liability Release

Feedback

contact information

worship times