Love, Joy, Peace...
VBS - CHILD Registration

A form should be submitted for each child registered.

Adult's Name Registering Child (First & Last) (Required)
Adult Relationship to Child (Required)
Adult Contact Number (Required)
Like to Receive Texts? (Required)
Adult Email Address
Child's Name (First & Last) (Required)
Child's Birth Date (Required)
Child's Last Grade Completed (Required)
Child's Shirt Size (cost = $10 each) (Required)
T-Shirts are $10 each
Child's Allergies / Special Needs
Please note any allergies or special needs
Emergency Contact Name (First & Last) (Required)
Emergency Contact Number (Required)
LIABILITY RELEASE & MEDICAL AUTHORIZATION (Required)
In consideration for the child’s participation in First Baptist Church Vacation Bible School (VBS), 2022, I/We, being 21 years of age or older, do for ourselves (myself) and on behalf of the minor child do hereby assume all risk and release, forever discharge and agree to hold harmless First Baptist Church, its staff and agents thereof from any and all liability, claims, or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned or child while participating in the VBS event. We/I understand recreation activities and other physical activity will be part of the event. We/I are the parents(s) or legal guardian(s) of this child, and hereby grant our (my) permission for him/her to participate fully in said activities, and hereby give our (my) permission to take the child to a doctor or hospital in the event of an emergency and hereby authorize treatment, and we assume the responsibility of all medical bills, if any.
MEDIA RELEASE (Required)
Is permission granted to photograph/video and release images for church and community use? I, the undersigned, do hereby grant or deny permission to First Baptist Church to use the image of myself or my child as marked by selection (s) below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images and/or video taken of myself or my child for use in materials for purposes of church ministry including but not limited to the church Facebook pages or website.
ILLNESS ACKNOWLEDGEMENT (Required)
In order to participate or observe VBS...First Baptist Church requires you to affirm that: 1) If you or your child exhibit any of the following symptoms of illness you will refrain from entering the premises until you are free of those symptoms for at least 24 hours. 2) If you or your child exhibit the following symptoms while on site you will be asked to vacate the premises immediately until you are free of symptoms for at least 24 hours. The above, symptoms being referred to are as follows: fever, cough, chills, fatigue, muscle aches, diarrhea, headache, sore throat, congestion or runny nose, nausea or vomiting, shortness of breath or any other symptoms of illness.
First Baptist Church - Luverne, MN
1033 North Jackson Street, Luverne, MN 56156
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