Kahului Baptist VBS 2025 Registration

Child's Info

Child's Name

Mailing Address

Birthday

Age

Last Grade Completed

Gender

Medical or other information we need to know. (Please include any food allergies.) If none, type

Photo and Video Release: We love to share the fun of VBS! Please let us know how we can use photos or videos of your child. Please read the options carefully.

Yes. You may use my child's photo or video for any promotional purpose, including on the church's social media accounts and website. Yes, with limitations. You may use my child's photo or video for internal church purposes (like in-service recaps), but not on public social media or websites. No. I do not grant permission for my child's photo or video to be used.

Parent/Legal Guardian Info

Parent/Legal Guardian Name

This address will receive a confirmation email

Phone

Parent/Legal Guardian Name (if applicable)

Phone

Emergency Contact Info (in addition to those listed above)

Leave blank if not applicable

Name

Phone

Name

Phone

Alternate Pickup Person(s)

CHILDREN NEED AUTHORIZATION TO BE BROUGHT IN AND OUT DAILY FROM THE PROGRAM. IN THE EVENT WE (Parents/Legal Guardians as listed above) are not able to sign our children in or out of your program, or cannot be reached for emergencies, our alternative person may act on our behalf and who we’ve informed for their status, authority, and responsibility:

Name of Alternate Person

Phone

Name of Alternate Person

Phone

I, the undersigned parent/guardian of child listed above, give permission for him/her to participate in VBS from Monday, July 14, 2025 through Thursday, July 17, 2025 8:00am-12:00pm, and Friday, July 18 5:30pm at Kahului Baptist Church.

I will be solely responsible for, and agree to release Kahului Baptist Church and its officers, directors, employees, representatives, and any other persons directly or indirectly involved with its operations, from any injuries or illness to my child, including the payment of any emergency medical and surgical care related to such injuries or illness.

In the event of an emergency, I understand that attempts will be made to contact me and emergency contacts, and if I/we not immediately available, I authorize VBS staff to call an emergency ambulance and to arrange for medical and surgical treatment and care by a physician chosen by the VBS staff. I have read this entire form and agree to adhere to it in its entirety.

I have read, understood, and agree to the statement above

By typing my name below, I am electronically signing this document.

By typing my name below, I am electronically signing this document. (leave blank if not applicable)

Kahului Baptist VBS 2025 Registration

Description

Please Fix the Following