VBS REGISTRATION | Rainbow COC

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Vacation Bible School Registration Form

Please fill out a separate form for each student.

STUDENT NAME:

STUDENT AGE:

STUDENT STREET ADDRESS:

CITY & ZIP CODE:

PARENT/GUARDIAN NAME:

PARENT/GUARDIAN PHONE:

WHAT GRADE DID THIS STUDENT JUST COMPLETE?

ANY ADDITIONAL INFORMATION THAT STAFF SHOULD BE AWARE OF?

EMERGENCY CONTACT:

NAME:

RELATIONSHIP TO STUDENT:

CONTACT NUMBER:

ALT CONTACT NUMBER:

RELEVANT MEDICAL INFORMATION:

DOES THE STUDENT HAVE ANY MEDICAL ISSUES WE NEED TO BE MADE AWARE OF?

ANY KNOWN ALLERGIES?

PHOTO RELEASE:

Rainbow Church of Christ may post pictures of Vacation Bible School activities and participants to social media, website, or their bulletin. I understand that my child may be included in photos and give my permission for their use.

I agree to the photo release

The information provided is correct to the best of my knowledge. The person herein described has permission to engage in all Vacation Bible School activities except as noted. My child will abide by the VBS rules and follow staff directives. I hereby give my permission to Rainbow Church of Christ to secure the proper medical treatment for my child in case of injury or illness.

I agree to the terms & conditions

SIGNATURE:

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