VBS 24 Child Registration

Child Registration for VBS 2025

Please fill out one form per child.

* Indicates required field

Child's Name *

First

Last

Child's Birthdate *

Grade Completed *

Allergies and/or Medical Information *

Parent/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Emergency Contact Phone 1 *

Emergency Contact Phone 2 *

Would you like more information about West Acres? *

Yes No

It is expressly desired that participant described herein be an active participant in the activities of Vacation Bible School (VBS) at West Acres Baptist Church. Participant is believed to be in satisfactory health and free from communicable disease. It is understood that there are certain risks involved in activities related to VBS. It is understood and agreed that West Acres shall not be responsible or legally liable for any losses of personal property or for any bodily injuries (or the results thereof) incurred and suffered by participant in connection with VBS. In the event I (parent/guardian) cannot be reached or am rendered unconscious, I hereby give permission to the physician selected by West Acres Staff to hospitalize, secure proper treatment for, order injections, anesthesia and/or surgery for my child in case of an emergency. I (parent/guardian) am giving West Acres permission for any photos or videos taken of myself/my child to be used at West Acres’ discretion in any of their promotional venues.

By clicking this box, I (parent/guardian) agree and consent to all above stated.

I, the parent/guardian, agree and consent to all above stated. *

I agree

Submit