VBS 2026 Registration: Emerald Crossing

Child's Name

Gender

Male Female

Birthdate

What grade is your child entering in Fall 2026? (If not yet in school, select their age group)

VBS Grade

Pre-K (4's & 5's) Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Parent/Guardian Name

Parent/Guardian Phone Number

Parent/Guardian Email

This address will receive a confirmation email

Address

Who (besides you) is authorized to pick up your child?

List Allergies/Medical Conditions

How did you hear about our VBS?

Door hanger From a friend I attend Grace Sign Facebook Internet Search Email Other

If you selected other, please describe here:

1. Consent for Participation & Basic First Aid I am the parent or legal guardian of the above-named child(ren) and I give my permission for them to attend Vacation Bible School (VBS) at Grace Baptist Church and participate in all VBS activities. I authorize VBS staff and volunteers to administer basic first aid (e.g., band-aids, ice packs, washing small scrapes) as needed during these activities.

2. Emergency Medical Treatment Grace Baptist Church will always attempt to contact the parent/guardian or designated emergency contact first in the event of any medical emergency. In the event that efforts to contact me or my designated emergency contact are unsuccessful, I authorize all medical, surgical, diagnostic, and hospital care or procedures which may be performed or prescribed for the above-named child(ren) by an on-site nurse, a licensed physician, or a hospital when deemed immediately necessary or advisable to safeguard my child’s health. I acknowledge that Grace Baptist Church will not be responsible for any medical expenses incurred.

Emergency Contact Name

Emergency Contact Relationship to Child

Emergency Contact Phone Number

3. Photo & Media Release (Please check one) During VBS, we occasionally take photos and videos of the kids engaging in activities, games, and crafts to share with our church community.

Please choose one of the following:

YES, I give permission for my child(ren) to be photographed/videoed during VBS, and for the images to be published, reproduced, or distributed by Grace Baptist Church in all outlets (including internet and church publications) without liability or limitation.

NO, please do not photograph or publish images of my child(ren).

Photo Release Selection

Yes No

Electronic Signature

Date

VBS 2026 Registration: Emerald Crossing

Description

Please Fix the Following