Child Name *

First Name

Last Name

Birthday *

MM

DD

YYYY

Parent Name / Guardian Name *

First Name

Last Name

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 *

(###)

###

####

Parent or Guardian 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 *

HOTO AND VIDEO RELEASE FORM FOR VBS AT THE FREEDOM CENTER CHURCH [2025] I hereby grant permission to The Freedom Center Church, its staff, agents, and representatives (collectively, the “Church”), to use photographs and/or video recordings of my child, taken during the 2025 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 further acknowledge that the Church may edit, alter, copy, exhibit, publish, or distribute these images and/or recordings for any lawful purpose, including publicity, illustration, advertising, and web content. I waive any right to inspect or approve the finished product where my child’s likeness appears. I hereby release and discharge The Freedom Center Church, its officers, employees, agents, and any third parties involved in the creation or publication of these photographs and/or video recordings, from any and all liability, claims, or causes of action arising out of or in connection with the taking, recording, digitizing, or publication of such images and/or recordings. By checking the box below, I confirm that I have read and understand the terms and conditions set forth above and agree to be bound by them.

I Agree