Gospel Life Church VBS 2023
Please fill out (1) form for each child and click submit.
Questions can be directed to vbs@gospellifechurch.net
Child Information:
Child's Name:
*
Birthdate:
*
Grade (next school year):
*
Please select one option.
Pre-Kindergarten
Kindergarten
1st
2nd
3rd
4th
5th
6th
Select Option
Pre-Kindergarten
Kindergarten
1st
2nd
3rd
4th
5th
6th
ALLERGIES:
Please note any restrictions:
Parent/Guardian Information
Name of Parents/Guardians:
*
Cell Phone # 1 (Please note which Parent/Guardian this number belongs to):
*
Cell Phone #2 (Please note which Parent/Guardian this number belongs to):
*
Email:
*
This address will receive a confirmation email
Address:
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Persons (other than above mentioned parents/guardians) authorized to sign child out:
How did you hear about our VBS?
Please select one option.
Attendee of Gospel Life Church
Word of Mouth - Family/Friend
Facebook
Sign in front of Church
Flyer/Ad in community
Permissions:
I understand that my child may participate in physical activities. As with any physical activity there is risk of injury. I fully accept this risk and hold harmless from any legal liability. Gospel Life Church and any persons involved in the Children's Ministry.
*
Please select all that apply.
In the event of an emergency that requires medical treatment for the above named child, I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the Children's Ministry Volunteers to secure the services of a licensed physician to provide the care necessary for my child's well being. I assume responsibility for all costs connected to any accident or treatment of my child.
*
Please select all that apply.
I understand that I am placing my child(ren) under the care of others at my own risk. Gospel Life Church (GLC) will take necessary precautions to help ensure the safety and health of my child(ren), but cannot make any such guarantee. I am also responsible for determining the health and wellness of my child(ren) prior to allowing participation in GLC’s children’s ministries and understand that a child that shows any symptoms of sickness may be denied entry. I hereby release, waive, indemnify, hold harmless and discharge Gospel Life Church, church officers and children’s ministry workers for any and all claims relating to COVID-19 or other sickness as a result of participation in GLC’s children’s ministry
*
Please select all that apply.
I also give permission for photo(s) of my child to appear on the Gospel Life Church's website, social media or literature as long as there is no identifying information shown.
Please select all that apply.
Submit
Description
Please fill out (1) form for each child and click submit.
Questions can be directed to vbs@gospellifechurch.net
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