Child Name *

First Name

Last Name

Birthday *

MM

DD

YYYY

Parent Name / Guardian Name *

First Name

Last Name

Phone *

(###)

###

####

Emergency Phone *

(###)

###

####

Authorized Pickup *

In the event you are unable to pick up your child or we are unable to get ahold of you.

First Name

Last Name

Authorized Pickup Phone *

(###)

###

####

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Medical Release *

MEDICAL RELEASE FORM FOR VBS AT THE FREEDOM CENTER CHURCH [2024]: I, hereby authorize my child named above to participate in the Vacation Bible School (VBS) program at The Freedom Center Church. In the event of an emergency, I authorize the VBS staff to obtain medical treatment for my child as they see fit. I understand that every effort will be made to contact me before any medical treatment is administered, but if I cannot be reached, I authorize the VBS staff to make medical decisions on my behalf. In addition, I certify that my child is in good health and has no known medical conditions that would prevent him/her from participating in VBS activities. I understand that it is my responsibility to inform the VBS staff of any medical conditions, allergies, or other health concerns that my child may have. I understand that participation in VBS activities may involve some physical activity and that there is always some risk of injury. I release The Freedom Center Church, its staff, and volunteers from any and all liability for any injuries, damages, or losses that my child may sustain as a result of his/her participation in VBS activities. By checking the box below, I acknowledge that I have read and understand the terms and conditions set forth above and that I agree to abide by them. I agree to the terms and conditions set forth above.

I Agree

Photo/Video Release *

PHOTO AND VIDEO RELEASE FORM FOR VBS AT THE FREEDOM CENTER CHURCH [2024]: I, hereby grant permission to The Freedom Center Church and its staff to use photographs and/or video recordings of my child named above, taken during the Vacation Bible School (VBS) program at The Freedom Center Church, for the purpose of promoting future VBS events or other church-related activities. I understand that these photographs and/or video recordings may be used in various media formats, including but not limited to, print publications, online publications, presentations, websites, social media platforms, and broadcast media. I agree that The Freedom Center Church may edit and use these photographs and/or video recordings for any lawful purpose, including but not limited to, publicity, illustration, advertising, and Web content. I release The Freedom Center Church, its employees, and any third parties involved in the creation or publication of these photographs and/or video recordings, from any liability connected with the taking, recording, digitizing, or publication of such photographs and/or video recordings. By checking the box below, I acknowledge that I have read and understand the terms and conditions set forth above and that I agree to abide by them. I agree to the terms and conditions set forth above.

I Agree