Stories Jesus Told

July 21-25, 2014

9:00 AM to 12:00 Noon
Tumbling Shoals Baptist Church
Vacation Bible School Registration Form
Name____________________________ Date of Birth_____________
Age___________Last Grade Completed_________________________
Parents Name(s)___________________________________________
Address__________________________________________________
City___________________________State_______Zip_____________
Phone_________________________Email_______________________
Emergency Contact
Person___________________________Phone____________________
Allergies/Conditions/Medications______________________________
Do you attend church? ______Where?___________________________
Who is authorized to transport you to and from VBS?
_________________________________________________________
Medical & Liability Release Valid July 21-25, 2014
In the event of sickness or some other medical emergency, I request my child receive
any medical attention or treatment deemed necessary by the church appointed
sponsors of the above event. Therefore, I give my permission to any hospital, doctor,
and/or health care provider to transport, treat and/or admit my child for care. I
understand that I am responsible for all expenses and charges for the treatment and
care of my child. In the event that I am not present at the time of the emergency or
cannot be contacted, the care of my child has been entrusted to the staff and
designated ministry leadership of Tumbling Shoals Baptist Church.

____________________________________________________________________
Signature of Parent
Date