Graham Presbyterian Church Vacation Bible School 2024 (6/24 – 6/27, 6:00 – 8:30 PM)

For all who are 3 (and potty trained) by 8/31/23 through rising 6th grade

Child’s Name: __________________________________________________________________

Guardian Name(s): ______________________________________________________________

Address: ______________________________________________________________________

Preferred contact #: ___________________________ Back up #: _________________________

E-mail: ____________________________________ Child age/entering grade: ______________

Emergency Contact: _______________________________ Relationship: ___________________

Preferred contact #: ___________________________ Back up #: _________________________

Allergies or other important info we need to know: ____________________________________


In the event of an emergency, Graham Presbyterian Church leaders have my permission to obtain medical treatment at my expense for my child. In case I cannot be contacted to authorize emergency care, this signed document authorizes medical care for my child to prevent increased injury or death. I do not hold anyone liable/responsible for any injury to my child while under the supervision of the church. I hereby give permission for my child to attend VBS at Graham Presbyterian Church. I also give permission for church staff, volunteers, and VBS leaders to take pictures/videos of my child with the understanding this media will be used in various church communications in physical formats and digital formats (such as church newsletters and Facebook posts).

Guardian consent signature: _____________________________________ Date: __________

May we contact you in the future regarding future church events?            (circle one)      Yes     No  

**NOTE: Children must wear closed toe shoes each night at VBS**