VBX Child Registration

Guardian's Name *

First Name

Last Name

Guardian's Cell Phone *

(###)

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Guardian #2 Name

First Name

Last Name

Guardian #2 Cell Phone

(###)

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Emergency Contact Name(if different)

First Name

Last Name

Emergency Contact Phone

(###)

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Student's Name *

First Name

Last Name

I give my permission for the VBX staff to administer basic first aid to my child(ren) in the event of an injury. I understand that the VBX staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me. I hereby grant First Baptist Maryville permission to copyright and use photographs/videos taken at VBX of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied. I give permission for my child(ren) to attend the Vacation Bible Experience (VBX) listed above. I understand that the information I give for this registration will only be used by First Baptist Maryville.

I agree