VBS 2026

Child Information

Child's Name

2025/2026 grade level?

Date of Birth (Month/Date/Year)

Choose one

Please list any food allergies or dietary restrictions

Please list any medical conditions or non food allergies

Parent/Guardian Information

Name (First & Last)

Relationship to child

Phone

This address will receive a confirmation email

Address

Emergency contacts

Please list atleast one adult other than youself

Name, Phone Number & Relationship to child

Media Wavier

- I hereby grant permission to Beech Grove Baptist Church to use my image/voice in any official church publications---printed or web-based---without further consideration. - I acknowledge the church's right to crop, edit, or otherwise treat any photo's recordings at its discretion. -I also acknowledge that the church may chose not to use my image or voice at this time but may do so at its own discretion at a later date. -I understand that once my image/voice is posted on Beech Grove Baptist Church's website or any of its social media profiles that it may then be downloaded by any computer user, anywhere in the world. -The church reserves the right to discontinue the use of any images/recordings at any time, without notice.

Therefore, I agree to indemnify and hold blameless the church, its pastor, staff, members, and designees from any claims arising from the use of my image or voice. I do not grant my permission for the church, its pastor, staff, members, and designees to the use of my child's image or voice

VBS 2026

Description

Please Fix the Following