VBS Registration Card
Child's NameAge
Address
Zip CodeHome PhoneCell Phone
Grade CompletedAllergies
My Child Has A Special Need/Learning Disability
Select OneMale Female
Home Church
Parent Guardian Names:
Email address
Yes I would like a T-Shirt for my child ($10, payable at first night of VBS)
Community Christian Church Medical & Liability Form
Medical Insurance CompanyPolicy ID #
Mother's/Guardian's Name Father's/Guardian's Name
Emergency Contact (Other than parent/guardian)
Emergency Phone Emergency Cell
You will be required to sign the following liability waiver on the first night of VBS

I (We) the parent(s) or legal guardian(s) of my (our) son or daughter hereby grant Community Christian Church the right to authorize emergency medical treatment for my son or daughter.

I also accept full responsibility for the risk of injury to my child/children while using the facilities of the church, and agree to release Community Christian Church and its employees/volunteers from all liability in the event of an injury.

Please Note:  All Medical & Liablity Release Forms will be shredded at the end of VBS.
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