Vacation Bible School

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Vacation Bible School Registration

The Refuge Church
Full Name of Parent/Guardian *

First Name Last Name
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Child Information
Child Information *
Pick Up Authorization

Authorized person/s to pickup your child(ren) after the Vacation Bible Study
Full Name 1 *

First Name Last Name
Relationship to Child *
Full Name 2

First Name Last Name
Relationship to Child
Emergency Contact Information
Emergency Contact 1 *

First Name Last Name
Relationship *
Phone Number *
Please enter a valid phone number.
Emergency Contact 2

First Name Last Name
Relationship
Phone Number
Please enter a valid phone number.
Permissions and Waiver
I/We, the undersigned, having legal custody of the child(ren) named on this registration form, give permission for my/our child(ren) to attend Vacation Bible School at The Refuge Church, located at 102 Front St., Smyrna, TN, from July 22–25, 2025, from 6:00 PM to 8:30 PM. I/We understand that there are inherent risks associated with participation in any church activity or event, including outdoor and physical activities.

I/We hereby release The Refuge Church, its pastors, employees, agents, and volunteer workers from any and all liability for injury, loss, or damage to person or property that may occur during the course of my/our child(ren)’s involvement in Vacation Bible School.

In the event of an emergency, I/We give permission for The Refuge Church staff or volunteers to seek and authorize any necessary medical treatment for my/our child(ren) by a licensed medical professional. I/We understand that I/we am/are responsible for the cost of any such medical care not covered by our insurance. I/We agree to hold harmless any medical personnel, hospitals, and The Refuge Church for decisions made in good faith during medical emergencies.

I/We affirm that the information provided in this registration is accurate to the best of my/our knowledge. I/We also agree to bring my/our child(ren) home at our own expense if they become ill or if deemed necessary by staff.

Additionally, I/We grant permission for The Refuge Church to use photographs or video taken of my/our child(ren) during VBS for church-related promotional materials, including but not limited to print, website, and social media use.
I have read and agree to the permissions and policies above. *

Yes
Date

Month Day Year
Date
Parent/Guardian Signature *

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Date
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Kingdom Seekers VBS

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More about us

Vacation Bible School Registration

Child Information

Pick Up Authorization

Emergency Contact Information

Permissions and Waiver

Kingdom Seekers VBS

The Refuge Church

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