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McDonald Road Seventh-Day Adventist Church

Location

5440 McDonald Road

McDonald, TN 37353

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Contact Geoff Starr:

304-834-2131

vbs@mrcsda.org

First, tell us about yourself:

Parent Information

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Emergency Contact Phone

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Alternate Pickup Name

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Alternate Pickup Phone

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Alternate Pickup 2 Name

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Alternate Pickup 2 Phone

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May we use your child’s photo in slide shows presented at VBS and the church service following, (church services are streamed live)? Images will not be used commercially. I hereby release the Georgia-Cumberland Conference of Seventh-day Adventist from all liability in connection with the private use of photos and videos of children listed.

Media Release

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Click here for your FREE, Buddies Ebook Pack

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 Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Gender

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Participants must be 5 years old or of age to enter Kindergarten in school to attend VBS. Younger siblings that are not old enough to attend cannot be dropped off to be watched by child care. Child care is only for those Volunteers that are volunteering the entire week.

Grade Entering

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Date Of Birth

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Vegan

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Please answer the following questions if this child has an allergy or medical condition that VBS staff should be aware of. If none, please leave blank and skip to the liability release.

Medical Concerns

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Allergies

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What are his/her reactions? (i.e. Hives, stop breathing, trouble breathing, need medication, etc...)

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What is the plan of action when he/she has an allergic reaction?

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Does he/she need to carry any medications or devices for his/her allergy?

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What medication and who will carry it?

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Comments

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Liability Release: By clicking yes below, I, the parent or guardian of the above mentioned child, a participant in Vacation Bible School sponsored by McDonald Road Seventh-day Adventist Church, McDonald, Tennessee, so hereby state that said child is physically and medically able to participate in the said activity. I do hereby release and discharge the McDonald Road Seventh-day Adventist Church and its authorized representatives and staff from all liability of any kind and character upon any claim, demand, or cause of action which might be asserted in behalf of said minor and/or myself against the McDonald Road Seventh-day Adventist Church, representatives, or staff. Furthermore, in the event of an accident, if said staff or representatives are unable to contact the undersigned, I hereby grant permission to said staff or representative to administer first aid, and/or take the participant to a medical facility for treatment.

Liability Release Authorization

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