Main Baptist Church
Vacation Bible School - 2021
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Name
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Age
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Grade Last Completed
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Address
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City
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Zip Code
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Cell Phone
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Parent/or Guardian Name
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Email
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Do You Have Internet/WIFI accessibility at home?
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Yes
No
Do you have a device (Laptop, Chromebook, Tablet, Desktop Computer) available?
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Yes
No
If yes, what type of device would you be using for VBS?
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Would you need transportation to pick up VBS materials?
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Yes
No
Would you prefer a noncontact delivery to your home?
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Yes
No
If a noncontact delivery, where should we leave the materials?
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Do you have any specific needs at this time (Food, Shelter, Medical Care)?
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Yes
No
If so, what are they?
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Would you like Main Baptist Church to assist you (if possible)?
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Yes
No
By signing this form, I hereby release any liability and waive all claims against Main Baptist Church, including any other persons or organization(s) with respect to participation in the programs and activities offered. I understand that my child’s participation in the activities provided by the church is my sole responsibility as parent or guardian. My signature below indicates that I understand and agree with this waiver in its entirety. have a verbal acknowledgement of your willingness to participate in Main Baptist Church’s Virtual Vacation Bible School. also agreeing to release any liability and waive all claims against Main Baptist Church, including any other persons or organization with respect to participation in the programs and activities offered.
Electronic Signature Below
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