June 11th - 15th @ 6:00PM - 8:30 PM
Contact Information (This person will recieve the confirmation email.)
VBS Participant Information (note: a separate form is required for each participant.)
Age: Enter MM/DD/YYYY (A calendar will appear. The birth year can be changed by using the back arrow, or by changing it after it appears in the box below.
Grade (Please enter grade for Fall 2023)
VBS 2023 (based on Fall 2023 school year)
Permission & Emergency Contact
Additional Pickup & Emergency Authorization:
Medical Authorization: I (parent/guardian) hereby authorize Calvary Baptist Church leaders to administer first aid and to obtain and consent to on my behalf any emergency first aid or medical care by any physician or hospital for my child (named above). I agree to abide and be bound by such decisions and consents as if made by me. I further authorize any physician, hospital or medical attendant to receive full and complete medical reports or information deemed necessary with respect to the treatment of my child listed above. Execution of this document shall operate as an authorization for such person(s) to receive any medical information which they require. I will also hold harmless and release from all liabilities Calvary Baptist Church, Cleburne, Texas and its staff members, and workers from any injuries and/or illnesses occurring to my child during any official activity including transportation as requested/noted below.
Photo Authorization: I/We the undersigned hereby consent to the use of my/our child’s photograph/video image/digital in any website, brochure, publication, or video produced by Calvary Baptist Church. I/We understand that this is on a voluntary basis and I/We will not be compensated for the use of my/our images.
