VBS - River of Life Worship Center

Parent/Guardian Name*

First Last

Please list all names of children with their ages and completed grade level [1 per line]*

Phone*

Address

Street Address Address Line 2 City State ZIP Code

Email*

Home Church

Please list all allergies and medical information:*

Please list 2 emergency contacts with their phone number:*

How did you hear about VBS?

Medical Waiver

I give permission for my child to participate in classes and/or activities at River of Life Worship Center. I authorize the volunteers and staff to administer emergency medical first aid treatment, or to call for emergency medical response. (If no, parent will be required to stay with child at all times)

Yes
No

Media Release

I give permission for my child's photograph/video to be used on the River of Life Worship Center's website and other social media outlets.

Yes
No

CAPTCHA

VBS 2023