Vacation Bible School (VBS) Registration *

Which VBS are you registering for?

Morning VBS for All Children (9 AM - Noon, Aug. 4-8)

Evening VBS for Special Needs Children Only (6 PM - 7:30 PM, Aug. 4-6)

Child *

First Name

Last Name

Parent/Guardian 1 *

First Name

Last Name

Parent/Guardian 2

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian 1 Phone *

(###)

###

####

Parent/Guardian 2 Phone

(###)

###

####

Child's Birthdate *

MM

DD

YYYY

My child may have a daily snack or treat. *

Yes

No

Yes, but my child has special dietary needs/allergies. (Please explain in the box below.)

Can My Child Get a Ride on the Church Bus?

We will contact you about the possibility of a bus in your area, and to make arrangements with you.

I would like my child to ride on the church bus, if possible.

PARTICIPATION AGREEMENT *

I acknowledge that participation in Faith Baptist Church's VBS ("the activity") involves risk to the participant (and to the participant’s parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, exposure to infectious/communicable disease, bodily injury, death, emotional injury, personal injury, property damage, and financial damage. In consideration for the opportunity to participate in the activity described above, the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to as the “activity sponsor”). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association.

I AGREE

DATA USAGE AGREEMENT *

I hereby grant, voluntarily and with full understanding, to Faith Baptist Church (“the Church"), a license to the following: 1. Use and storage of my name and image, by means of digital or film photography, video photography, audio recording or other documentation, with respect to the activity, namely Vacation Bible School (“the activity”), of the Church. 2. Use of any stored data including my name and image in printed publications of the Church. 3. Use of any stored data including my name and image in electronic publications of the Church. 4. Use of any stored data including my name and image in any Web site created by or for the Church for its sole benefit. 5. If I am signing this agreement on behalf of a minor child, I hereby warrant that I am the legal parent or guardian of the child and that I have the legal authority to sign this agreement on behalf of the child. 6. If a dispute over this agreement or any claim for damages arises, I agree to resolve the matter through a mutually acceptable alternative dispute resolution process. If I cannot agree with the Church upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association for final resolution.

I AGREE