VACATION BIBLE SCHOOL

WAVE HELLO TO THIS YEAR’S VBS THEME: BREAKER ROCK BEACH!

VBS 2024 will be held nightly from 6 to 8pm from June 24 through June 28.

Come learn about God’s rock-solid truth in a world of shifting sands.

Rising kindergarten (must be at least 4 years old) to 5th graders welcome!

*DOORS OPEN 10 MINUTES EARLY*

Registration cost: FREE

Please fill out the form below completely for EACH child participating.

*Denotes required field

Vacation Bible School 2024

Participant Information

Participant Name *

Age *

Grade Completed in Spring 2024 *

Date of Birth *

Parent/Legal Guardian Information

*Note: This contact information will be used in the case of an emergency.*

Parent/Legal Guardian Name *

Relationship To Participant *

Email Address *

Home Phone Number *

Work Phone Number

Cell Phone Number *

Street Address *

City *

State *

Zip Code *

Medical Profile

Generally, the participant's health is: *

Please explain the participant’s condition:

List any medical difficulties for which the participant is being treated:

List any medicines or substances to which the participant is allergic: *

List any medications the participant takes:

List any special diets or needs:

Family Physician

Phone Number

Insurance Company

Phone Number

Subscriber Name

Subscriber Number

Place of Employment

Phone Number

Subscriber Occupation

Permission for Medical Treatment, Photograph/Video Notice and Release and Indemnity

My permission is granted for the camp or event director, church official, any camp or event staffer, or adult present or in charge of First Aid to obtain necessary medical attention in case of sickness or injury to my child. Also, I understand that as a participant, my child may be photographed or videotaped during normal camp or event activities and these photos/videos may be used in promotional materials. I, the undersigned, do hereby verify that the above information is correct and I do hereby release and forever discharge Parkview Baptist Church from any and all claims, demands, actions or causes of action, past, present or future, arising out of any damage or injury while participating in this camp.

I agree *

I Agree

If you are human, leave this field blank.