God's Wonder Workshop

Registration Form

Child's First Name

Child's Last Name

Child's Age

Allergies (if any)

Parent/Guardian's First Name

Parent/Guardian's Last Name

E-mail

Phone

Emergency Contact Name

Emergency Contact Number

How many days do you plan to attend? (This is only to help us estimate attendance. You may change your response later if needed)

How did you find out about this program?

By clicking this box, I, the parent/guardian named above agree with the statements below.

In the event of a medical emergency, I, the parent or guardian named above, authorize the ministry staff of the Church of the Living God to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.
I, named above, undertake and agree to indemnify and hold blameless the ministry staff, Church of the Living God, its pastors and leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of the
Church of the Living God, as well as of any medical treatment authorized by the supervising individuals representing the church.
This consent and authorization is effective when participating in the Vacation Bible School events of the Church of the Living God.
The Church of the Living God is collecting and retaining this personal information for the purpose of enrolling your child in our Vacation Bible School, to assign the student to the appropriate classes and contact the appropriate persons if/when needed regarding program updates or emergencies. This information may be maintained permanently where it is a requirement of our insurance company.