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Participant Registration

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Hixson UMC

Location

5301 Old Hixson Pike

Hixson, TN 37343

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Contact Sarah Jolley:

423-463-7522

sjolley6032@gmail.com

First, Tell Us About Yourself:

Parent Information

As you register, please keep in mind that VBS is for fully potty trained children ages 4 through graduated 5th grade.

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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Contact Phone 2

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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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Does your family have a Bible in the home? If not, we would love to provide one to you!

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If you have a church home, what church does your family attend? (Type "none" if you do not have a church home).

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LEGAL RELEASE - I understand that Hixson UMC's VBS involves activities such as, but not limited to the following: recreation, worship, Bible study, as well as crafts & snacks. I am aware that certain risks may exist during such activities. I hereby consent for participant(s) to participate in these activities and agree to assume all risks associated with such participation. I hereby release, and hold harmless, Hixson UMC and its agents and employees from any and all liability, actions, causes of actions, claims, expenses, and damages on account of any injury to children in my care during Hixson UMC VBS.

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CHILD PROTECTION AGREEMENT: PARENTAL CONSENT - We are so thankful that your family is desiring to stay connected with Hixson UMC VBS activities! We believe strongly in teaching God's Word in a child-safe environment. Because of this belief, we want to be above reproach any time our adult volunteers or staff interact with minors. This statement grants parental/legal guardian's consent for your child(ren) to participate in Rome VBS with Hixson UMC's leaders and ministers. These adults have undergone required back-ground checks, completed safety training and understand Safe Sanctuaries required by Hixson UMC in order to be allowed to serve minors in our communities as representatives of the church.

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General Health Protocols - I agree to follow Hixson UMC's health and safety protocols that will be in place during VBS. I understand that the participate should be fever free and symptom free for 24 hours before attending VBS activities.

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We are excited to have you join us for Rome VBS! How did you hear about it?

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity 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

On Thursday, June 25th at 6:30,
all are invited to our Family Celebration Night
as we have dinner together and celebrate a great time at VBS!

First Name

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Last Name

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Grade Leaving

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Gender

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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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Allergies or Medical Concerns

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Please list any FOOD allergies.

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Is there anything else you would like for us to know about your child?

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PHOTO/AUDIO RELEASE - By participating, I give permission for images, video, and audio of the participant to be used in whole or in part in publication, audio-visual presentations, promotional materials, social media, or in other similar ways. I wave the right to financial reimbursement or any liability related to the reproduction of such photos or video, now or in the future. Removal of an image from social media may be requested through the ministry leader.

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DIGITAL SIGNATURE - Please enter your FULL NAME to serve as an honest digital signature. In signing this registration, you agree that all responses are true and accurate and were submitted by you of your own accord.

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