VBS 2023 Special Needs Registration

Get ready for a walk on the wild side at First Christian Church Kilgore's annual Special Needs Vacation Bible School. Open to all children (ages 5 and up) and adults with special needs, June 26-28th from 6-8 PM.

This year's theme is Wild Life. So dust off your safari hats as we head off the beaten trail to explore some of the God's craziest creations! Together we will learn how WILD it is that Jesus invites us to share our stories, spend time with God, and use our gifts! It is sure to be a ROAR-ing good time, so invite all your friends.

June 26-28th from 6-8 PM.

Attendee's Information

Attendee's Name

Date of Birth

Gender

Male Female Other

Grade (if applicable)

Allergies or Food Restrictions:

Diagnosis

Medication

Hygiene Capabilities (Bathroom)

Behavioral Support Needs

What makes me uncomfortable

What makes me comfortable

Additional Helpful Hints

Parent/Guardian's Information

Parent(s)/Guardian(s) Names

Parent(s)/Guardian(s) Phone Number(s)

Address

This address will receive a confirmation email

Emergency Contact (if parents can't be reached)

Emergency Contact Phone

Declaration of Consent

By checking yes to the items you are consenting to the statement. By checking no you are not consenting to the statement.

I give permission to First Christian Church to make necessary decisions for medical treatment if parents/guardian are unable to be reached.

Yes, I agree No, I do not consent

I give First Christian Church permission to use my child's picture in presentation, church publication, church website, and Facebook page.

Yes, I give permission No, I do not give permission

I release First Christian Church, all staff and volunteers from all liability for any additional illness or injury to my child, and for any accidental damage or destruction of my child's property during an activity at church.

Yes, I agree No, I do not agree

I give permission for my child to have a snow cone.

Yes, enjoy No, not a good idea Can we discuss

Any additional information you wish to let us know.

VBS 2023 Special Needs Registration

Description

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