First, tell us about yourself:

Parent Information

I hereby authorize and consent to an x-ray, examination, anesthesia, medical, surgical, or dental diagnosis or treatment and hospital care to be rendered under the general or specific supervision and on the advise of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. *I also authorize (if I so provide it) the administration of my child's prescribed epinephrine auto injector.

As parent/legal guardian, I remain legally responsible for any actions taken by my son/daughter. Signing hereby releases Grace Fellowship Chapel and the directors thereof from any responsibility and liability for injury or loss occurring while participating in any activities at the church, or under it's supervision.

By checking the box you will be emailed your Free Buddies Ebook Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Roar VBS and other faith-building resources. Click to learn more about Lifetree.

Tell us about your participant:

Participants must be 4 years old by Jan 1st, 2019 up to entering 5th grade.

Please choose from the menu below the grade your child will enter in September 2019 *(Prek-5th only, Nursery is not available)

I hereby authorize Grace Fellowship Chapel to use images of my child in the VBS slideshow to be shown Friday during camp and presented Sunday at Grace Fellowship Chapel.

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