Vacation Bible School | Living Waters Christian Center

Vacation Bible School Registration

5949 – 51 Spruce Street
Philadelphia, Pa 19139

Phone # 215-247-5483
overflow2lwcc@gmail.com

Child's Name *

First

Last

Child's Age *

Last school grade(s) completed *

Name of Parent *

First

Last

Parent Cell Phone *

Name of Second Parent

First

Last

Second Parent Cell Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Email *

Home Church

Allergies or other medical conditions

Emergency Contact *

First

Last

Emergency Phone *

Relationship to Child *

: I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS 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 the above-named church permission to copyright and use photographs/videos taken at VBS 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 (named above) to attend the Vacation Bible School (VBS) listed above. I understand that the information I give for this registration will only be used by the VBS hosting church, and that all registration information will be removed from the hosting site by December 31 of this year.