VBS Registration Form - Maranatha Baptist Church

Parent/Guardian's Name *

First

Last

Phone *

Email *

Street Address *

City, State *

Emergency Contact Name

Please list a friend or relative to contact in the event of an emergency and the parent cannot be reached.

Emergency Contact Number

Child's Name, Gender, & Age *

Additional Child's Name, Gender, & Age

Required *

In the event of emergency and the parent cannot be reached, I, the undersigned parent/guardian of the child(ren) listed above, do hereby authorize adult volunteers of Maranatha Baptist Church as agent(s) for the undersigned to consent to any medical or surgical care advisable by any accredited physician or surgeon in an approved emergency clinic or hospital.

Required *

I further release from any liability Maranatha Baptist Church and any of its ministries, leaders, or volunteers in the event of an injury, accident or illness before, during, or after this event. This agreement does not apply to claims for intentional misconduct or gross negligence. I verify that my child(ren) have not been diagnosed with COVID-19 or experienced any related symptoms in the last 14 days (fever, fatigue, dry cough, difficulty in breathing, etc.). I accept full responsibility for my child(ren)’s safety and actions and recognize that by their participation, they may be at risk of contracting COVID-19. I agree to hold harmless Maranatha Baptist Church, its leaders, and its volunteers from any lawsuit, costs, or claims due to injury, loss, or death from or related to COVID-19.

Required (copy) *

I, the undersigned, grant permission for Maranatha Baptist Church to photograph/video my child(ren) during this event and use such media for craft projects, slideshows, the church website, and/or the church Facebook page. I understand that no identifying information will be displayed.

Please sign by typing your name below. *

By typing your name, you verify that you are the parent/guardian of the child(ren)/ward(s) listed above, that you grant permission for your child(ren)/ward(s) to attend Super Saturday at Maranatha Baptist Church, and that you are in agreement to the terms listed above concerning medical care, liability, and photography.

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