New Hope VBS Child Registration June 22-25

Child's Name

DOB (MM/DD/YY)

Gender

Male Female

Grade entering this Fall '26

Dietary Restrictions or allergies (if applicable)

Parent/Guardian Name (First, Last)

Parent/Guardian Phone Number

Parent/Guardian Email

This address will receive a confirmation email

I grant New Hope, its representatives and employees the right to take photographs of my child. I authorize New Hope, its assignees and transferees to copyright, use and publish the same in print and/or electronically. I agree that New Hope may use such photographs of my child with or without his/her name for any lawful purpose, including, for example such purposes as publicity, illustration, advertising and web content.

Yes No

I give my permission for my child to participate in VBS 2026 sponsored by New Hope Wesleyan Church.. In the unlikely event of an emergency, I grant permission for the church to authorize and consent to any x-ray, medical or surgical diagnosis for treatment or hospital care to be rendered under the general or special supervision and on the advice of a licensed physician, surgeon, anesthesiologist, dentist, or other qualified medical personnel acting under their supervision in the treatment found necessary for the correction of conditions considered detrimental to the health and well being of my child. I understand and I am liable and agree to pay all costs and expenses incurred in connection with such medical and dental services rendered to my child.

Yes No

New Hope VBS Child Registration June 22-25

Description

Please Fix the Following