Includes dinner, bible lessons, drama, music, games, crafts & T-Shirt

FREE

June 12-16th, 6:00pm – 9:00pm with
special Musical Program on Saturday, June 17th at 11:00am

For Children Ages 4-12, Entering Grades PRE-K to 7th Grade 

VBS Registration Section
Child's Name *
Child's Name
Parent/Guardian Name *
Parent/Guardian Name
Emergency Phone *
Emergency Phone
2nd Phone Number
2nd Phone Number
Medical Care permission section
Date *
Date
Subscriber's Name *
Subscriber's Name
Insurance Company Emergency Number *
Insurance Company Emergency Number
Has he/she had any surgery or serious illness within the last 3 years? *
Is he/she required to take any medication? *
Does he/she have any allergies or allergic reaction to any medication? *
Is he/she presently under a doctor’s care? *

*By registering my child for the Galena Park Church of God 7th Day VBS, I am authorizing it and/or parties designated to photograph my child and use photographs in all forms of media, for purposes of publicity, display and audiovisual use. I understand that the term photograph, as used herein, encompasses both still photographs, audio recording and motion picture footage. I hereby release Galena Park Church of God Seventh Day and any of its associates from any claims associated with COPPA.

Also by registering my child, I give my permission to participate in all activities of the Galena Park Church of God Seventh Day. I understand all events will have adult supervision. In consideration of the benefits to be derived from these activities, I hereby voluntarily waive any claim against Galena Park Church of God Seventh Day, sponsors, and volunteers. I further agree to direct my son/daughter to conform to the fullest with the directions and instructions of the sponsors in charge. This consent and release is in effect until I give Galena Park Church of God Seventh Day instructions to the contrary.

Also by registering my child, I hereby authorize emergency medical care or first-aid treatment as needed for my child in the event of illness or injury during any sponsored activity of Galena Park Church of God Seventh Day. This permit is in effect until I give Galena Park Church of God Seventh Day written notice to the contrary.