Please Read the Following and Check the Box that You Agree
By agreeing and signing this registration, as a parent/guardian I acknowledge that my child is physically able to participate in and has my permission to engage in all of the activities listed below* during Vacation Bible School, June 12 - June 16, 2017 at Belle Aire Baptist Church. Please note that I have listed any medical or physical challenges my child has that leaders and/or physicians should be aware of and/or that may hinder my child from participating in any activities during this event. I further understand that there is no Accidental Insurance furnished by the church. I understand that my personal medical and hospitalization insurance will provide primary coverage should any medical treatment be required. I further understand that, in the event my child requires medical or dental treatment while engaged in the event, reasonable efforts will be made to contact me; however, if I cannot be reached, I hereby consent and give permission to the church’s sponsor or any adult counselor acting on behalf of the church with respect to the event, as agent for me, to consent to any X-ray examination, injections, anesthesia, medical, dental, or surgical diagnosis and treatment, and hospital care and treatment advised and supervised by a physician, surgeon, or dentist (as appropriate) licensed to practice under the laws of the state where the services are rendered, either as an outpatient or in any hospital. To the best of my knowledge, I have listed above all of my child’s current medical challenges and other pertinent information. I also understand that video footage and/or my child’s picture may be taken during VBS and can be used in church videos, publications, and/or future promotions. I am over eighteen years of age, and legally competent to execute this permission/release form; and that before signing this permission/release form claimant has fully informed himself/herself of the activities and hazards of this event and the contents and meaning of this permission/release form and has executed it with full knowledge thereof.
*Activities include: relay games, water dodgeball, water obstacle course, kickball, water balloon toss