Child Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Parent / Guardian Name *

First Name

Last Name

Best contact number during VBS *

(###)

###

####

I'm planning on my child attending these days: *

Please be as accurate as possible as this helps with planning which group your child will be placed in.

Monday

Tuesday

Wednesday

Thursday

Friday

Photo Release Agreement *

Photos and/or videos are taken by our staff during the course of VBS. These photos and/or videos may be used on the libertybiblechurch.com website, on our Facebook or Instagram pages or in slideshows shown during or after VBS. Children in photos are not specifically identified by name or age. All children must have a photo release as we can not guarantee that children will not inadvertently appear in a photo.

I understand that my child may appear in photos and/or videos from this event

Medical Release Agreement *

Medical volunteers will be on hand during VBS at Liberty Bible. In the case of a minor injury (small cuts & scrapes, bruises, etc.) our medical volunteers will provide minor first aid. In the event of a more serious injury, we will contact the parent and/or 911 emergency services.

In my absence, I authorize the staff of Liberty Bible to engage medical treatment for my child as well as provide first aid care on site if deemed necessary.

VBS Optional Extras

Exact cash, check or credit card payments will be accepted at VBS (please visit the merchandise table to get your items). Requests for items marked "sold-out" can't be honored.

T-Shirt, Kids X-Small ($7)

T-Shirt, Kids Small ($7)

T-Shirt, Kids Medium ($7)

T-Shirt, Kids Large ($7)

T-Shirt, Adult Small ($10)

T-Shirt, Adult Medium ($10)

VBS CD ($7)