VBS 2025

Vacation Bible School Registration - 2025
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Participant's Information

Parent/Guardian Information

Medical Information

Consent & Agreement

CONSENT AND RELEASE FORM FOR CHURCH ACTIVITY

  • I, the undersigned parent(s) or guardian(s), hereby consent to my child, participating in the activities connected with Vacation Bible School, an activity sponsored by Pleasantville Baptist Church on the following dates: June 24-27, 2025. I understand that this activity will include the following: Bible Lessons, playing outside, running, active games, having a snack - If your child has allergies, please specify on this consent form, bring a snack, and give it to their teacher being CLEARLY MARKED WITH CHILD'S NAME, AGE & GRADE - inform your child to eat only what you give them. I certify that my child is able to participate in any and all of these activities. If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them below. In the event that an emergency occurs, I may be reached at the telephone number listed below. If I cannot be reached within a reasonable period of time, as determined by church officials, I hereby authorize the church or one of the adult sponsors, to make emergency medical decisions for my child. If there are any activities that I do not want my child to be involved in, I have listed them below.
  • I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I do, for myself and for my child, heirs and assigns, hereby irrevocably and unconditionally release, acquit and forever discharge Pleasantville Baptist Church and its agents, employees, and volunteers from any and all liability, actions, causes of actions, claims, expenses, obligations and damages of any nature whatsoever, which I now have or which may arise in the future, in connection with my child's participation in the described activity or in any other associated activities including, but not limited to, any injury to my child or property, even injury resulting in death.
  • I further state that I HAVE CAREFULLY READ AND UNDERSTAND THE FOREGOING RELEASE AND I KNOW THE CONTENTS HEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. I understand that this is a legally binding agreement.
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