VBS

Keepers of the Kingdom VBS is FULL
for ages Kindergarten-6th grade.
Preschool registration is STILL OPEN.
We are excited for what is going to be a really FUN week!

Registration Only OPEN for PRESCHOOLERS (age 3 & 4)

* Indicates required field

Child's Name *

First

Last

Gender *

Birthdate *

T-shirt Size *

Age at Time of VBS *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian Name *

First

Last

Parent/Guardian Phone Number *

Parent/Guardian Email *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Name of Home Church *

Who Can Pick Up Your Child? *

Food Allergies/Medical Concerns (explain below) *

Liability/Medical Release (RELEASE OF ALL CLAIMS)
We, the undersigned parent/legal guardian of the above named child(ren), do hereby release, forever discharge, and agree to hold harmless Mountain View Bible Church and the representatives thereof from any and all liability, claims, or demands from personal injury, sickness, or death, as well as property damage and expenses of any nature whatsoever which may be incurred by my child in the course of participation in the Keepers of the Kingdom VBS held June 19-23, 2023. Furthermore, we agree to assume all responsibility for any of the previously mentioned occurrences. We give our permission for our child to participate in the aforementioned program and its activities.
In the event of an emergency that requires medical treatment for the above-named child(ren), I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the Keepers of the Kingdom VBS volunteers at Mountain View Bible Church to obtain the services of a licensed physician to provide the care necessary for my child’s well being. I assume responsibility for all costs connected to any accident or treatment of my child.

BY SUBMITTING THIS FORM I AM EFFECTIVELY SIGNING AND AGREEING TO THE ABOVE STATEMENT

Submit

Keepers of the Kingdom VBS is FULLfor ages Kindergarten-6th grade.Preschool registration is STILL OPEN.We are excited for what is going to be a really FUN week!

Registration Only OPEN for PRESCHOOLERS (age 3 & 4)

Keepers of the Kingdom VBS is FULL
for ages Kindergarten-6th grade.
Preschool registration is STILL OPEN.
We are excited for what is going to be a really FUN week!