Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

I understand this is a family style VBS and acknowledge that I must remain onsite with my kids. Parent Responsibility

Student Information

Gender

Birth Date

Age Group

Food Allergies

Details

Medical Concerns

Details

I, the undersigned, hereby release and discharge The Gathering at the Barn, its staff, volunteers, and affiliates from any and all liability for injuries or damages that may occur during my child’s participation in Vacation Bible School activities. This release is intended to discharge in advance The Gathering at the Barn, its officials, officers, employees, volunteers and agents from liability, even though it is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assignees Liability Release

In the event of an emergency, I hereby authorize the VBS staff, volunteers, or affiliates to secure any necessary medical treatment for my child. I understand that all reasonable efforts will be made to contact me before such action is taken. Medical Consent

Photo Release

I grant permission for photos and videos of my child to be taken during VBS and used for church promotional purposes (bulletins, website, social media, etc.).

I have more students to register