Child Information (one form per child)

Parent/Guardian Information

Emergency Contact information (if different from person above)

Medical & Health Information

Permission to administer basic first aid/seek emergency medical care

Permissions & Agreements

Photo / Video Release: I give permission for photographs and videos of my child to be used for church promotional purposes (website, bulletin, social media).

2.  Plan to Protect Agreement: I understand that all VBS volunteers have been screened and trained according to Castor EMC’s Plan to Protect policy. I agree to abide by program rules and communicate any concerns promptly.

My child will be:

 Dropped off and picked up by parent/guardian