2017 VACATION BIBLE SCHOOL
This form must be completed by a parent or guardian of the child(ren) being registered.
Want to register as an adult volunteer? Click HERE.
Step 1: How many participants are you registering?
Child Participant #1 Information
Child Participant #2 Information
Child Participant #3 Information
Child Participant #4 Information
Emergency Contact Information
(Please provide an emergency contact other than the parent/guardian provided above.)
Liability and Medical Release
I hereby grant permission for the child named above to engage in the various activities sponsored by St. Luke’s Episcopal Church as part of the 2017 Vacation Bible School Program. I assume all risk and hazards and do hereby release and agree to hold harmless St. Luke’s Episcopal Church and associated volunteers, agents, and employees from all liability for personal injury or property damage for all actions taken in good faith during Vacation Bible School activities. I understand that photographs of my child may be taken and give permission for use of these photographs in promotional materials by either church, including on church websites and brochures. (At no time will children be identified by name or shown individually in said photographs.) In the event I cannot be reached or cannot communicate in an emergency, I hereby give my permission to the leaders of Vacation Bible School to secure appropriate medical services and for the physician(s), hospital, or medical service(s) selected by the leaders of Vacation Bible School to hospitalize, treat, and to order injection, anesthesia, or surgery for my child or myself as named above.
BY ACKNOWLEDGING AND ENTERING MY INITIALS BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.