VBS 2024 at Grant Road

*Denotes Required Field * Title

You are registering your child for VBS at Hillsdale Baptist Church (Grant Rd)

PARENT(S) DETAILS:

* Name (First and Last):

* Street Address:

* City/Town:

* Province:

* Postal Code:

* Phone Number: ( ) -

* Primary Email Address:

Home Church (if applicable):

* Will you attend the free hot dog lunch on August 16?

* How many people from your family will attend the hot dog lunch?

REGISTER YOUR CHILD(REN):

* Child's First Name:

* Child's Last Name:

* Child's Gender:

* Month of Birth:

* Day of Birth:

* Year of Birth:

* Grade going into:

* School child attends:

Allergies, other medical conditions, or notes:

I need to register a 2nd child.

* Child's First Name:

* Child's Last Name:

* Child's Gender:

* Month of Birth:

* Day of Birth:

* Year of Birth:

* Grade going into:

* School child attends:

Allergies, other medical conditions, or notes:

I need to register a 3rd child.

* Child's First Name:

* Child's Last Name:

* Child's Gender:

* Month of Birth:

* Day of Birth:

* Year of Birth:

* Grade going into:

* School child attends:

Allergies, other medical conditions, or notes:

I need to register a 4th child.

* Child's First Name:

* Child's Last Name:

* Child's Gender:

* Month of Birth:

* Day of Birth:

* Year of Birth:

* Grade going into:

* School child attends:

Allergies, other medical conditions, or notes:

I need to register a 5th child.

* Child's First Name:

* Child's Last Name:

* Child's Gender:

* Month of Birth:

* Day of Birth:

* Year of Birth:

* Grade going into:

* School child attends:

Allergies, other medical conditions, or notes:

I need to register a 6th child.

* Child's First Name:

* Child's Last Name:

* Child's Gender:

* Month of Birth:

* Day of Birth:

* Year of Birth:

* Grade going into:

* School child attends:

Allergies, other medical conditions, or notes:

EMERGENCY CONTACT DURING VBS:

* Primary emergency contact name:

* Primary contact relationship to Child:

* Primary contact phone number: ( ) -

* Secondary contact name:

* Secondary contact relationship to Child:

* Primary emergency contact phone number: ( ) -

How did you hear about our VBS?

WAIVER AND RELEASE FORM:

VBS 2024, Hillsdale Baptist Church, August 12-16, 2024

Dear Parent/Guardian,

Our desire as a church is the safety of everyone involved at VBS. Therefore, precautions are being taken for the health and safety of your child. However, there is always a potential risk. On August 12-16, 2024 all registrants will participate in VBS activities at one of our church facilities (either 101 Munroe Pl. or 336 Durham Dr). Participation in activities at VBS, including indoor/outdoor games, may carry a risk of undesired and unanticipated consequences. Be aware that in the event that a child requires medical treatment we will act quickly to provide care, and parents/guardians will be notified. Please carefully read the waiver and release statement below and sign.

WAIVER AND RELEASE: I, the parent/guardian responsible for this child, release Hillsdale Baptist Church of any liability related to the child's participation in the VBS event held August 12-16, 2024 at Hillsdale Baptist Church.

I understand that while precautions have been taken for the health and safety of all participants of VBS, my child’s participation in VBS 2024 may have undesired and unanticipated consequences. By my signature, I hereby release and discharge Hillsdale Baptist Church and all affiliates, members, directors, officers, volunteers and employees from any and all actions, suits, claims, demands, liabilities, including negligence, and expenses I have now or may have in future in connection with, arising from or related to my child’s involvement with or participation in this activity.

Date I am agreeing to waiver and release:

* Month:

* Day:

Year: 2024

Full Name of Parent/Guardian for waiver:

* Parent/Guardian:

Virtual Signature: By clicking this box I declare that I have read and agree to the above waiver form. (A copy of the waiver form and this registration will be sent to your email as confirmation)

* I agree:

I also understand that Hillsdale Baptist Church retains the right to use, for church information and advertising purposes, photographs and video footage of children taken during VBS 2024 (However, Hillsdale Baptist Church will not post photos or video of children online without obtaining further permission.)

* I agree: