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Spark Studios - VBS  - July 18-22, 2022
Living Hope Baptist Church - VBS Registration Form
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Spark Studios
Parent/ Guardian Name *
Relationship to Child(ren) *
Contact Number *
Email *
Secondary (Emergency) Contact Person *
Relationship of Child(ren) to Emergency Contact Person *
Contact Number of Emergency Contact Person *
Do you have a home church? *
Name of Church
Child #1 - First and Last Name
Date of Birth
MM
/
DD
/
YYYY
Age
Grade Just Completed
Clear selection
Gender
Clear selection
Food Allergies/ Medical Needs/ Other
Child #2 - First and Last Name
Date of Birth
MM
/
DD
/
YYYY
Age
Grade Just Completed
Clear selection
Gender
Clear selection
Food Allergies/ Medical Needs/ Other
Child #3 - First and Last Name
Date of Birth
MM
/
DD
/
YYYY
Age
Grade Just Completed
Clear selection
Gender
Clear selection
Food Allergies/ Medical Needs/ Other
Child #4 - First and Last Name
Date of Birth
MM
/
DD
/
YYYY
Age
Grade Just Completed
Clear selection
Gender
Clear selection
Food Allergies/ Medical Needs/ Other
I (we) give Living Hope Baptist Church permission to use my child(ren)'s photos or videos of participation in this activity/event. I (we) release Living Hope Baptist Church of any and all liability.   *
I (We) the parent(s) or guardian(s) of the above listed child(ren), grant permission for our child(ren) to participate in the LHBC VBS program, to be held at Living Hope Baptist Church, and to receive medical treatment if necessary. If I (we) or the listed alternate emergency contact cannot be reached, I (we) give permission to the staff of Living Hope Baptist Church to secure the services of a licensed physician to provide the necessary care for my child(ren).                                              I (We) also agree to hold harmless Living Hope Baptist Church and all its participants from any liability and assume all risk of injury, damage or expenses as the result of participation in the activities of this event/activity.  Typed full name will act as signature.                                                                                 *
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