VBS Registration Form 2019

Vacation Bible School 2019
Child Information

Small (6-8) Medium (10-12) Large (14-16)

Your Information

Address*

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Emergency Contact

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RELEASE*

I hereby consent that my child, under the supervision of the VBS staff of Palos Heights CRC, may: 1) Have his/her name, picture, portrait, or photograph used in all forms and media and in all manners, including composite representations, for advertising, trade, or any other lawful purposes, and I waive any right to inspect or approve the finished version(s), including written copy that may be created and appear in connection therewith. 2) Receive emergency medical treatment at a local medical facility as necessary in the event parent, guardian, or emergency contact cannot be reached to arrange for such treatment.

© 2019 Palos Heights Christian Reformed Church   |   7059 West 127th Street, Palos Heights, IL US 60463