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VBS REGISTRATION FORM

I, *
I,
,hereby authorize Next Generation Ministries to obtain medical care for,
Child One Name *
Child One Name
Child One Birthday *
Child One Birthday
Child Two Name
Child Two Name
Child Two
Child Two Birthday
Child Two Birthday
Child Three Name
Child Three Name
Child Three Birthday
Child Three Birthday
Child Four Name
Child Four Name
Child Four Birthday
Child Four Birthday
in the event of illness/injury during the time period from July 9 - July 13, 2018 at The Door Church 
Vacation Bible School (VBS).
EMERGENCY INFORMATION
Parent Contact Information
Parent Name
Parent Name
Parent Phone
Parent Phone
Parent Address
Parent Address
Other Name
Other Name
Other Phone
Other Phone
INFORMATION
PHOTOGRAPHY & VIDEO
I grant permission for my child(ren)’s image, likeness and sound of their voice to be recorded on audio or video, without other compensation, and published on The Door Church’s website, or other promotional media. I understand that their image may be edited, copied, or exhibited and waive the right to inspect or approve the finished product wherein their likeness appears. My consent is given for one calendar year from the date that I sign this form.
-
QUEST 119
Register my child(ren) for Quest 119 Bible Hour, for the 2018-2019 school year.
CONSENT
BY CHECKING THE BOX BELOW YOU AS A PARENT OR AUTHORIZED GUARDIAN VERIFY THAT ALL INFORMATION ABOVE IS CORRECT AND ACCURATE.
*