WPC VBS Sign up June 2, 2023June 2, 2023 by Aaron Orner VBS REGISTRATION FORM 2023VBS 2023 REGISTRATION FORM JULY 17-20 from 9am-noon for Rising Kindergarten - Rising 5th GradersChild's First Name Child's Last Name Parent's First Name Parent's Last Name Street Address City State Zipcode Parent's Phone Number Parent's Email Address Child's Date of Birth Child's Grade in Fall 2023? Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradeAllergies or Medical Conditions We Should Be Aware Of:Please share any concerns you have about your child participating at VBS:Emergency Contact Name Emergency Phone Number Parent ConsentI/we, the undersigned parent(s)/guardian(s) of the child listed above, a minor, do hereby authorize adult volunteers of Wimberley Presbyterian Church as agent(s) for the undersigned, to consent to any medical or surgical care deemed advisable by any accredited physician or surgeon inan approved emergency clinic or hospital. I further release from any liability Wimberley Presbyterian Church, any of its ministries or leaders in the event of an accident en route, during and returning from the above mentioned event. This agreement does not apply to claims for intentional misconduct or gross negligence. Photography ConsentI hereby grant to the Wimberley Presbyterian Church the right to photograph my dependent, the child listed above, and use the photo and or other digital reproduction of him/her or other reproduction of his/her physical likeness for publication processes, whether electronic, print, digital or electronic publishing via the Internet.