SHCC VBS 2019 online registration

July 21-25 1019 | 5:30 - 8:15pm (Check-in & activities start at 5pm)

Welcome! Please fill out the form below to submit your child/children for this years VBS!

(One form per family)

 


Parent/Guardian Name *
Parent/Guardian Name
Phone *
Phone
Address *
Address
Person(s) authorized to pick up children (besides parents)
Person(s) authorized to pick up children (besides parents)
Child #1 Name *
Child #1 Name
(Grade going into)
Child #1 birthday *
Child #1 birthday
Child #2 Name
Child #2 Name
(grade going into
Child #2 birthday
Child #2 birthday
Child #3 Name
Child #3 Name
(grade going into)
Child #3 birthday
Child #3 birthday
Name of Doctor *
Name of Doctor
Allergies, illnesses, or medications. List "none" if there are none
Medical release/waiver *
I (we), the undersigned parent(s) or legal guardian(s) of the minor child(ren) listed on this form, certify that they have my full approval to participate in Singing Hills Christian Church Vacation Bible School, from July 21, 2019 to July 25, 2019. Further, I hereby authorize the Church's Children Directors or volunteers and adult supervisors of SHCC as agent(s) for the undersigned, to consent to any medical or surgical care deemed advisable by accredited physician or surgeon, in an approved emergency clinic or hospital, to obtain any necessary medical assistance needed in case of accident or injury to the child(ren). I understand that every effort will be made to contact me. I also understand that the insurance information provided above will be used in any such emergency, and I agree to assume full financial responsibility for any expense incurred for said treatment. I hereby release SHCC, it's employees and agents, including, but not limited to, its volunteers and adult supervisors, from any liability and all legal and financial responsibility, I also agree to indemnify the church, its employees and agents, including, but not limited to its volunteers and adult supervisors, against any other claims by any other parties arising from the child(ren)'s participation in this activity. **BY REGISTERING, YOU ARE ACCEPTING THE TERMS OF THE MEDICAL RELEASE AS WELL AS GIVING SHCC PERMISSION TO USE VIDEO AND PHOTOS THAT INCLUDE YOUR CHILD(REN) TO PROMOTE VBS AND SHCC**