Vacation Bible School | Mount Olive United Methodist Church

STUDENT’S NAME *

STREET ADDRESS *

CITY *

STATE *

ZIP *

PHONE *

PARENT/GUARDIAN NAME *

PARENT/GUARDIAN EMAIL

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT NUMBER *

ALLERGIES OR SPECIAL NEEDS/ACCOMODATIONS *

GRADE COMPLETED (AGES 5-12)

SHIRT SIZE (PLEASE SELECT ONE): *

Youth Extra Small
Youth Extra Large
Youth Small
Adult Small
Youth Medium
Adult Medium
Youth Large
Adult Large

PERSON WHO WILL PICK UP THIS CHILD FROM VBS *

(PLEASE SIGN IF YOU GIVE PERMISSION) PHOTO RELEASE: MT. OLIVE UNITED METHODIST CHURCH HAS MY PERMISSION TO USE MY CHILD'S PHOTOGRAPHY PUBLICLY IN VBS MATERIALS. I UNDERSTAND THE IMAGES MAY BE USED IN PRINT PUBLICATIONS, ONLINE PUBLICATIONS, PRESENTATIONS, WEBSITES, AND SOCIAL MEDIA. I ALSO UNDERSTAND THAT NO ROYALTY, FEE, OR OTHER COMPENSATION SHALL BECOME PAYABLE TO ME BY REASON OF SUCH USE.

MY CHILD WILL NEED TRANSPORTATION