VACATION bible experience 2021 "CACTUSVILLE" (VIRTUAL VBX) Registration

Parent or Guardian's Name

Phone

Child's Name (1)

Birthdate (Child 1)

Age (Child 1)

Gender (Child 1)

Last School Grade Attended (Child 1)

Allergies or other medical conditions (child 1)

Child's Name (2)

Birthdate (Child 2)

Age (Child 2)

Gender (Child 2)

Last School Grade Attended (Child 2)

Allergies or other medical conditions (child 2)

Child's Name (3)

Birthdate (Child 3)

Age (Child 3)

Gender (Child 3)

Last School Grade Attended (Child 3)

Allergies or other medical conditions (child 3)

Child's Name (4)

Birthdate (Child 4)

Age (Child 4)

Gender (Child 4)

Last School Grade Attended (Child 4)

Allergies or other medical conditions (child 4)

Child's Name (5)

Birthdate (Child 5)

Age (Child 5)

Gender (Child 5)

Last Grade School Attended (Child 5)

Allergies or other medical conditions (child 5)

Child's Name (6)

Birthdate (Child 6)

Age (Child 6)

Gender (Child 6)

Last Grade School Attended (Child 6)

Allergies or other medical conditions (child 6)

Disclaimer Notice

Fairhavens will do its best to supervise and keep children safe during VBS. However, Fairhavens cannot be held responsible for any injuries or accidents caused while attending VBS.

Consent to Photography/Video

Registration of my child/ren give permission to Fairhavens Filipino Seventh-day Adventist Church to photograph/video my child/ren and use such photograph(s)/video(s) in all forms of media and all promotional purposes knowing I will not receive any payment for my time or expenses or any royalty for the publication.