Page 233 | Providence Baptist Church

Child's Name (Required)

Date of Birth (Required)

School Grade Completed (Required)

Parent/Sponsor Name (Required)

Relationship to O (Required)

Address (Required)

E-Mail (Required)

Emergency Contact (Required)

Additional Emergency Contact (optional)

Permission to Attend (Required)

I give permission for my child (named above) to attend the Vacation Bible School (VBS) listed above. I understand that the information I give for this registration will only be used by Providence Baptist Church.

Allergies or other medical issues

First Aid Permission (Required)

I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact me but may also contact emergency services in the event of a significant injury, and all expenses for such emergency services will be paid by me.

Permission to Photograph (Required)

I hereby grant VBS staff permission to take photographs and videos of my child (named above). Photographs may be posted on the church’s Facebook page without the child’s name.

Permission to ride Church Van

I grant permission for the above-named child to be transported from Dreamers Day Care to Providence Baptist Church via the church van. I understand that my child will be under the supervision of adult church volunteers/staff during this ride and that I am responsible for picking up my child at the church each evening at the end of VBS. I acknowledge and understand that there are inherent risks associated with travel, and I release the Providence Baptist Church and its representatives from any and all liability for any accidents, injuries, or incidents that may occur during this transportation. I understand that no child safety seats are provided.

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Worship Services

10 Providence Lane, Daleville, AL 36322

Sunday Connect for All Ages | 9:30 am

Sunday Worship Service | 10:30 am

Wednesday Prayer Service-Youth-TeamKID: 6:00 pm

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