Vacation Bible School - First Presbyterian Church Granbury

Child's Name

Male or Female

Parent or Guardian Name & Phone Number

Address

Zip

Age

Birth Date

If (with the

School Grade COMPLETED

Emergency Contact & Phone Number

Other than the parents, who can pick up this student & phone number?

Brothers & Sisters with age

During VBS I can be reached at: (with phone number)

Does the child have diabetes? (YES/ NO) If yes explain.

Does the child have allergies? (YES/ NO) If yes explain.

Does the child have any other medical condition or other concerns that the staff should know about?

Adult T-Shirt Sizes

Church Home

PERMISSION TO PARTICIPATE AND RELEASE OF LIABILITY *

Signature & Date …………………………………….. I give permission for my, above named child, to participate in activities at First Presbyterian Church Granbury, and consent and agree to hold harmless First Presbyterian Church, their agents, employees, or volunteer assistants from all claims that I or they might have arising out of my child’s participation. This permission includes the use of the bounce house/water slide for 2025 Summer VBS. _____ (Y / N) In case of emergency, I give my authorization to provide whatever emergency care is necessary for my child’s safety and assume primary responsibility for payment.