RAINFOREST FALLS VBS 2026 CHILD REGISTRATION

Child(ren) Information

First Name

Last Name

Grade Just Completed

Gender

Birthdate

Allergies

Other Special Needs

Parent/Guardian Information

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number (Please best number in case of emergency)

Email

Emergency Contact

Please provide a name and phone number of an individual other than yourself to be reached in case of an emergency and you are unreachable.

First Name

Last Name

Relationship to Child(ren)

Phone Number

Authorizations

Please read and check applicable boxes below.

I hereby grant permission to the minor(s) designated to participate in the Vacation Bible School program of Lockport Alliance Church and I release Lockport Alliance Church of any liability in case of accident or emergency.

Agree

Disagree

I hereby grant Lockport Alliance Church staff permission to post photographs of my child on Lockport Alliance Church Facebook or Webpage.

Agree

Disagree

In case of medical emergency for the minor(s) designated, I hereby authorize Vacation Bible School staff of Lockport Alliance Church to act on my behalf if they are unable to reach me or emergency contacts and to seek treatment as they best judge to be necessary.

Agree

Disagree

Signature of Registering Parent/Guardian

Is there a friend (of the same age) your child would like to be in a crew with?

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Volunteer Registration Is Below

Adult or Youth Volunteer

Youth

Adult

If Youth, Grade JUST FINISHED Year

If Youth, Parent/Guardian Name

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number (If Youth, Parent's Phone)

Email

Allergies

PHOTOGRAPHIC RELEASE: I hereby release to Lockport Alliance Church the rights of my (or my youth's) image, or likeness, for the purpose of Lockport Alliance Church's newsletters, websites, fund development efforts, and/or newpapers.

Signature

If Youth, Parent/Guardian Signature

Emergency Contact Information

Contact First Name

Contact Last Name

Contact Phone Number

Do you have a child(ren) for:

Nursery (0-3)

Child(ren) Name and Age

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RAINFOREST FALLS VBS 2026 CHILD REGISTRATION

Child(ren) Information

Parent/Guardian Information

Emergency Contact

Authorizations

Volunteer Registration Is Below

Emergency Contact Information

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Lockport Alliance Church