2023 VBS Registration Parent/Guardian InformationParent/Guardian Name: *Phone *Phone number of Parent/GuardianEmail Address *Email Address of Parent/Guardian who is registering child(ren) for VBS.Street Address *Apartment, suite, etcCity *ZIP / Postal Code *MediaDo we have your permission to take and use photos and videos of your child(ren) for VBS related posts on the church website, church social media, or show during a church service? *YesNo (Note: This also means we'll be unable to include them in our usual VBS recap video)We may take photos or video of children participating in various parts of VBS to post on our church website, church social media, or show during a church service. By Answering 'Yes' you are granting us permission to do so.How did you hear about our VBS? *ChurchE-mailInvited by Family/FriendPosted FlyerSocial MediaOtherOther person(s) authorized to pick up your child(ren):List the name of anyone you want to have permission to pick up your child(ren) from VBS.Authorized Person's NameMedical ReleaseMedical Release Waiver Consent *I (we), the undersigned parent(s) or legal guardian(s) of the minor(s) listed below/on the reverse, grant permission for my child(ren) to participate fully in Vacation Bible School (hereinafter referred to as “VBS”) activities from June 5, 2023 – June 9, 2023 at The Church at Tubac. Further permission is hereby given to The Church at Tubac to provide emergency medical treatment in the event he/she is ill or injured. I do hereby authorize and consent to any reasonable medical treatment as deemed necessary by a licensed physician/medical personnel. It is understood that this authorization is given in advance of any specific diagnosis or treatment being required but is given to provide authority and power to render care which the aforementioned physician/medical personnel, in his or her best judgment, may deem advisable. It is also understood that effort will be made to reach his/her parent(s), legal guardian(s), or emergency contact(s) prior to rendering treatment, but that any treatment will not be withheld if the aforementioned cannot be reached. I understand the nature of VBS and do hereby release The Church at Tubac, its volunteers, its staff, and representatives from any liability for accidents or injury sustained by my child(ren) in conjunction with VBS. Phone (For medical emergencies)Emergency ContactsInformation of emergency contacts we can reach if Parent/Legal Guardian is not available in an emergencyEmergency Contact NameEmergency Contact Phone #Child(ren)'s InfoEnter the information for the child(ren) you are registering for VBSChild's Name: *Child's Age (Years) *Please enter your child's age (in years). Must be between ages 4 and 12.Select T-Shirt Size: *(OUT OF STOCK) Youth X-Small (4-6)(OUT OF STOCK) Youth Small (6-8)(OUT OF STOCK) Youth Medium (8-10)(OUT OF STOCK) Youth Large (12-14)(OUT OF STOCK) Youth XL (16-18)(OUT OF STOCK) Adult MediumAdult LargeLIMITED AVAILABILITY. SIZE NOT GUARANTEED. See Size Chart below for more infoSize ChartInfo For Medical ReleaseDate of Birth *Does your child have any allergies? *YesNoIf yes, please list allergies:Does your child have any medical or special needs, including medications currently being used? *YesNoIf yes, please list them:Doctor's NameOptionalDoctor's Phone #OptionalVerification and acceptance of form info *I agree that the information I have entered in this registration form is correct (to my knowledge), and I have provided all relevant information regarding medical concerns such as food allergies, and I confirm my acceptance or denial of the requested permission listed in this form.SignatureStart signing your signature hereYour browser does not support e-Signature field.By entering your digital signature you are saying the information you have entered in this registration form is correct (to your knowledge) and you have provided any relevant information regarding medical concerns such as food allergies as well as the acceptance or denial of requested permission and liability release listed in this formSubmit RegistrationSave Answers and Complete LaterPlease do not fill in this field.
