Child's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Parent/Guardian's Name *

First Name

Last Name

Phone *

(###)

###

####

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mailing Address (if different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Photography release *

Throughout the event, photos may be taken of the children and the activities they will be doing, primarily to show them to the congregation. Please indicate whether or not photos are allowed to be taken of your child.

I give permission for photos to be taken of my child.

I DO NOT want photos to be taken of my child.

*

Photographs taken may be used for promotional material, shown to the congregation as a slideshow, or posted on the church's website.

I give permission for photos of my child to be used as described above.

I DO NOT want any photos of my child to be used as described above.

Waiver *

By entering their name below and submitting this form, the adult registrant, parent, or other legal guardian of a registrant under 18 years of age acknowledges and agrees that all registrants who enter Vacation Bible School, who use the facilities and equipment, and participate in the activities will waive any and all claims, actions, suits, liabilities and demands whatsoever for bodily injury and/or death of the registrant which arise against the Evangelical Free Church of Wainwright and any owner and operator of it and all of its employees, volunteers, instructors, agents and associates. I understand that it is my responsibility to inform the Evangelical Free Church of Wainwright in writing of any physical ailment which would affect my child’s participation in the camp program and/or activities.

First Name

Last Name