Participant First Name *

 
Participant Last Name *

 
What grade will your child be entering in the Fall of 2017? *

**Only Pre-K (3s/4s) children that are from the FBC Madison CDC and children of members of FBC Madison may sign up as a Pre-K participant.  All other children must be entering Kindergarten or older.

 
Parent/Guardian First Name *

 
Parent/Guardian Last Name *

 
What is the best phone number to use in case of emergency? *

(mobile preferred)
 
What is your child's date of birth? *

 
Please list all allergies/medical needs that that VBS leadership at FBC Madison should be aware of *

If your child has no allergies, please type "none".
 
Membership and Attendance at FBC Madison

 
Is your child a regular attender or member at FBC Madison? *

     
 
If your child does not regularly attend FBC Madison, would you like more information about the Student and Family Ministry at FBC Madison?

     
 
VBS Child Behavior Agreement


We want everyone to have an amazing time at Passport to Peru VBS!  Everyone needs to do their part. Below are some guidelines to help our children have an awesome time!

1.  {{answer_nr7x}}  will be respectful of others -- other children, the VBS crew leaders, and station leaders.
2. {{answer_nr7x}} will listen to all instructions.
3. {{answer_nr7x}} will follow all directions.
4. {{answer_nr7x}} will show respect to FBC Madison property. *

By clicking 'Yes', you agree that  you and your child have reviewed the above statement and both agree to the VBS behavior standards as stated above.
     
 
VBS Parent/Guardian Expectations and Roles

At FBC Madison's Passport to Peru VBS, we want to make every effort to get to know the parents/guardians of the children in attendance.

We want you as the parent/guardian of {{answer_nr7x}} to feel completely comfortable and secure having your child hang out with us for a few hours during our VBS week.

We also want you to:
1) Partner with us in prayer as our children learn more about God's gifts and the role of Jesus in their lives.
2) Make sure all our children are kept safe by walking them inside when dropping them off and coming inside when it is time to pick up.
3) Commit to asking your children about their day, week, and everything they have learned and experienced at Passport to Peru VBS. *

*By clicking 'Yes', you as the parent/guardian of the child listed above, agree to said expectations and roles.
     
 
FBC Madison VBS Child Consents

The consents and releases contained below are valid for VBS at FBC Madison from June 12-16, 2017.
 
Participation and Medical Release
I, {{answer_50503438}} {{answer_50720163}}, as the legal parent/guardian of {{answer_nr7x}} {{answer_50503342}} give consent for him/her to participate in all activities including but not limited to: worship/celebration, crafts, bible study, recreation, and snack time.

I, {{answer_50503438}} {{answer_50720163}}, give consent to FBC Madison and their leadership to provide first-aid to {{answer_nr7x}} {{answer_50503342}}.

I, {{answer_50503438}} {{answer_50720163}}, give my consent for {{answer_nr7x}} {{answer_50503342}} to receive additional immediate medical attention in case of emergency while being accompanied by a church staff member or other VBS leader that has completed a background check.  

I, {{answer_50503438}} {{answer_50720163}}, will be contacted at {{answer_50503512}} if additional emergency medical attention is required.

In the event a decision is required in an emergency, said church representative may make any decisions regarding the emergency after first trying to reach and consult {{answer_50503438}} .  Thereafter, said church representative shall continue to attempt to notify {{answer_50503438}} until one of {{answer_nr7x}} 's parents/guardians are contacted. *

This agreement is specific to VBS at FBC Madison and applies to the dates June 12-16, 2017.
     
 
Video/Photo Consent

I, {{answer_50503438}} give permission for {{answer_nr7x}} {{answer_50503342}} to be videoed and photographed while attending Passport to Peru VBS at FBC Madison.

I release any photographs or videos taken of {{answer_nr7x}}{{answer_50503342}} , by representatives of FBC Madison to be used throughout the church, on the church website, church Facebook Pages, and Instagram Accounts. *

     
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