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I am registering for: *

VBS only

WITW only

VBS and WITW

BBFC Vacation Bible School Registration

What:

VBS

Who:

Kids, leaving grades Pre-K - 11

When:

Dates: June 17, 2024 - June 21, 2024

Time: 6:30 pm - 8:30 pm

Check in: 6:00 pm

Check out: 8:30 pm - 9:00 pm

Where:

Aurthur T. Jones Family Life Center (Gym and first floor rooms)

Your Text Here

BBFC Vacation Bible School and Week in the Word Registration

What:

WITW

Who:

Adults 19+

When:

Dates: June 17, 2024 - June 21, 2024

Time: 6:30 pm - 8:30 pm

Where:

Aurthur T. Jones Family Life Center (Second floor rooms)

Parent/Guardian Information

Today's Date * +

First and Last Name: *

Email *

Phone Number *

Child Information

How many children are you registering? *

Child's Name *

Child's Date of Birth * +

Child's Grade *

Child's Name *

Child's Date of Birth * +

Child's Grade *

Child's Name *

Child's Date of Birth * +

Child's Grade *

Child's Name *

Child's Date of Birth * +

Child's Grade *

Child's Name *

Child's Date of Birth * +

Child's Grade *

Medical Needs and History

1. Is your child presently being treated for an injury/sickness or taking any medication? *

No

Yes (please explain): Yes (please explain):

2. Does your child have, or have they ever had, any of the following? (Please check all that apply) *

3. If you made any selections above, please explain. Please note if your child uses an epi pen, asthma pump, etc.

4. Have you or has anyone in your household suffered from any of the following Covid-19 related symptoms within the past 14 days? (Please check all that apply) *

5. Does your child have a physical handicap or illness that would prevent them from participating in normal rigorous activity? *

No

Yes (please explain): Yes (please explain):

Consent and Release

1. Permission: *

I give my permission for my child(ren) to participate in this event at the dates and times shown above.

I give permission to the event leaders and volunteers to render First Aid if the need arises and provide further medical attention as needed.

2. I, the undersigned, being the parent or legal guardian of the child(ren) named above, do hereby consent to the participation of my child(ren) in all scheduled youth activities of Bible-Based Fellowship, Inc., and any other supervised activities customarily associated with Chosen Generation Student Ministries, including discussion topics (relationships, how to handle emotions, hygiene, bullying, and spiritual self-defense) and overnight or weekend youth trips. Further, I certify that my child(ren) is/are physically fit and adequately prepared to participate in all recreational and sporting events. If I wish to revoke this consent for any reason, I will promptly notify the youth leader in writing. (Initial below) *

3. I understand that I will be notified in the case of a medical emergency. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event that my child(ren) is/are injured or become(s) ill. I authorize one or more of the persons listed below to make emergency medical care decisions on behalf of my child(ren), if required by law or a health care provider (in addition to youth chaperones). I further understand that Bible-Based Fellowship, Inc. will not be responsible for medical expenses incurred solely on the basis of this authorization. I further agree to notify the youth director in writing of any health changes that would restrict my child(ren)'s participation in any normal youth activities. I also understand that the youth director and designated adult chaperones reserve the right to restrict my child(ren) from any activity that they do not feel is within the physical capabilities of my child(ren). *

4. I, the undersigned legal guardian, on behalf of myself as a parent and guardian and on behalf of my minor child(ren), do hereby release Bible-Based Fellowship, Inc. and its pastors, employees, agents, volunteers, and affiliates from liability in case of any and all illnesses, injury, or loss, as well as claims, damages, or actions of any nature whatsoever, even if resulting from the negligence of Bible-Based Fellowship, Inc. and even if resulting from negligence, actions, judgments, decisions, or errors in the administration of medicines or medical care by Bible-Based Fellowship, Inc. for any event or activity in which my minor child(ren) participates at or with Bible-Based Fellowship, Inc. (Initial below) *

5. I, for myself and my minor child(ren), hereby authorize the use by publication, display, or public use of my or my child(ren)'s photograph or any likeness in advertising, promotion, or reporting of events of Bible-Based Fellowship, Inc. or any activity in which Bible-Based Fellowship, Inc. is associated and I therefore hereby waive and release in perpetuity any and all rights and claims for damages I and/or my minor child(ren) may have against Bible-Based Fellowship, Inc. from any and all claims, damages, or actions of any nature whatsoever, including but not limited to claims pursuant to Chapter 540, Florida Statutes (https://m.flsenate.gov/Statutes/540.08), as a result of such use or display. (Initial below) *

6. By signing below, I confirm that I have read the entire BBFC Parent Consent and Release Form and voluntarily accept the conditions stated herein as a requirement to my child's (children's) participation in events and activities involving Bible-Based Fellowship, Inc. I agree that unless specifically revoked, in writing and signed by me, this Consent and Release will remain in full force and effect for the entire year, except as otherwise provided. I understand that participation may take place only with a fully executed form in the possession of Bible-Based Fellowship, Inc.

Parent/Guardian signature *

clear

Do you have any dietary restrictions? *

What breakout session would you like to register for? (The session you select will be the one you journey with all week) *

Sharing and Showcasing the Faith: Share and broadcast the Gospel in various places and spaces

Serving and Sanding: How to serve with your Spiritual Gifts

Prayer Priming and Word Welding: Be molded by the word of God and develop a prayer life that sticks

Asthma	Diabetes
Allergies	Kidney disease
Heart condition	Seizure disorders
None of the above

Fever or chills	Cough
Shortness of breath or difficulty breathing	Fatigue
Muscle or body aches	Headache
New loss of taste or smell	Sore throat
Congestion or runny nose	Nausea or vomiting
Diarrhea	None of the above