Kids Bible Camp 2019 Registration Form
One form per family
Child's Name
Age
Child's Name
Age
Child's Name
Age
Child's Name
Age
Address
Home Phone Number
Cell Phone Number
Number of family members participating in Babylon VBS
Will parents be helping in other areas of Babylon VBS?
Yes
No
Which area?
In case of emergency, contact: (name and phone number)
Please state any allergies or medical conditions your child has, and if they will require individual support at VBS.
Home church:
Name of a friend your child might like to be with:
Individual Consent and Release
On behalf of myself or the child identified below for whom I am the parent or legal guardian, I hereby:
1 .
consent to the use of my/my child's name, photograph, voice, statements, image, and likeness (the "Materials") by The Presbyterian Church in Canada for any promotional, publicity, programming, or communications purposes, in any media, in perpetuity, without compensation or notice;
2.
waive my/my child's rights to the integrity of the Materials, the right to be associated with the Materials, and any other similar rights in favour of The Presbyterian Church in Canada;
3.
release The Presbyterian Church in Canada, its administrators, partners, affiliates, employees, representatives, and agents from any liability or claims that relate in any way to the use of the Materials in the manner described above; and
4.
represent and warrant that: (a) I have all of the rights in the Materials and that The Presbyterian Church in Canada's use of the Materials will not violate or infringe upon the rights of any third party; and (b) I have reached the age of majority in my jurisdiction of residence.
Name
Child's Name (if applicable)
Date
- -
Please note
We may require your signature upon drop-off of your child/ren.
I do not consent to the use of my/my child's name, photograph, voice, statements, image, or likeness
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