Vacation Bible School

ROAD TRIP

On The Go With God

Sunday, July 27 thru Thursday, July 31

(5:30p until 8:00p)

Dinner Provided

First Name
Last Name
City
State
Zip
First Name
Last Name

IN CASE OF AN EMERGENCY, WHO CAN WE CONTACT?

Consent and Certification

I, the undersigned, being the parent or legal guardian of the child named above, do hereby consent to the participation of my child in the activities sponsored by First United Methodist Church. I certify that my child is physically fit and adequately prepared to participate in children’s activities.

Medical Treatment Authorization

I understand that I will be notified in the case of a medical emergency. However, in the event that I cannot be reached, I authorize the providing of necessary medical services in the event that my child is injured or becomes ill. I authorize an adult volunteer(s) designated by the pastor of First United Methodist Church to make emergency medical care decisions on behalf of my child, if required by law or a health care provider.  I authorize these persons to act in my place to consent to all necessary and appropriated x-ray examinations, anesthetic, medical or surgical diagnosis, or treatment, and hospital care.

I understand that First United Methodist Church will not be responsible for medical expenses incurred solely on the basis of this authorization. I also understand that the designated adult volunteers reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child.

Media Authorization and Release

I authorize First United Methodist Church the right to take photos of my child and release such photos without my child’s name to be used for publicity in:

  • First United Methodist Church Printed Materials
  • First United Methodist Church Digital Content (website, social media, etc.)