Westlock Alliance Church

Parent's Name (required)

Address

Phone Number(required) (cell)

Your Email

Child's Name (required)

MF

Going into grade (required)

Shirt Size
---YSYMYLSML

preferred music format:
CDDigital

Emergency Contact

Emergency Contact Phone number

I Authorize these people to pick up my child from camp.

Is there anyone who is not allowed access to your child?

EMERGENCY INFORMATION
Your child’s heath and personal information is collected to ensure the safety and well-being of each person involved in our church ministry. This information will only be seen by our camp staff and will be kept in a secure place.

Please list any allergies

Please list any medications currently being used

List any other health problems/important information:

I (parent/guardian) have read, understood and agree with the above and herby release and discharge all parties associated with Vacation Bible School from any and all claims, demands, actions, and causes of action, that I/we or my/our child(ren) incur(s).

VIDEO/STILL PHOTOGRAPHY AUTHORIZATION FORM
I herby authorize the staff of Vacation Bible School to take video and still photos of my child during VBS. These videos and still pictures could be used for future promotional material.

Any additional information you would like to provide