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 *

I, the undersigned, hereby authorize the child or individual mentioned in this form (hereinafter referred to as "the participant") 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 and/or volunteers to seek and obtain medical treatment for the participant as they deem necessary. While every effort will be made to contact me prior to administering medical care, if I am unreachable, I give my consent for the VBS staff to make medical decisions on my behalf. Additionally, I affirm that the participant is in good health and does not have any medical conditions that would prevent participation in VBS activities. I understand that it is my responsibility to inform the VBS staff in writing of any existing medical conditions, allergies, or other health concerns related to the participant. I acknowledge that participation in VBS activities may involve physical activities, and that there are inherent risks of injury. By signing below, I release The Freedom Center Church, its staff, volunteers, and affiliates from any and all liability for any injuries, damages, or losses that the participant may sustain as a result of their participation in VBS activities. By checking the box below, I confirm that I have read and understood the terms and conditions outlined above, and I agree to abide by them.

I Agree

Photo/Video Release *

PHOTO 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 the child or individual mentioned in this form (hereinafter referred to as "the participant"), 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 a variety of media formats, including but not limited to print publications, online publications, presentations, websites, social media platforms, broadcast media, and other forms of advertising or promotional materials. I acknowledge that the Church may edit, alter, copy, exhibit, publish, or distribute these images and/or recordings for any lawful purpose, including but not limited to publicity, illustration, advertising, and web content. I waive any right to inspect or approve the finished product in which the participant’s likeness appears, including, but not limited to, on social media platforms, promotional materials, and any advertising produced by the Church. I hereby release and discharge The Freedom Center Church, its officers, employees, agents, volunteers, and any third parties involved in the creation, publication, or distribution 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, publication, or distribution of such images and/or recordings, in any medium, including social media and advertising. By checking the box below, I confirm that I have read and understand the terms and conditions outlined above and agree to be bound by them.

I Agree