Vacation Bible Xperience August 13-17, 2017 REGISTRATION FORM * indicates required field Child Name* Gender:* Male Female Date of Birth:* Age: Allergies/Medical Conditions:* 2nd Child Name 2nd Child Gender Male Female 2nd Child Date of Birth 2nd Child Age Allergies/Medical Condition Parent/Guardian name(s):* Email: Address: Telephone No.* Home Mobile Church Affiliation (if applicable) Additional info. I am willing to volunteer at VBS * By submitting this registration form: I authorize Henderson Hwy SDA Church (HHSDA) to provide supervision and care for my child registered above. I consent to the use of photographs and video of my child by HHSDA. I understand that reasonable safety precautions will be taken. I understand that in case of an emergency medical treatment will be administered and that all efforts will be made to contact me. I understand that my child has voluntarily chosen to participate in all activities including singing, bible stories, indoor and outdoor sports activities, crafts and snacks. I understand that my child will be asked to discontinue participating should he/she disregard expected behavior guidelines and that any necessary transportation arrangements will be my responsibility. I Agree:* NOTE: Please submit this form then complete additional forms if you are registering more children.