Vacation Bible School Child Registration

Registration is closed for the 2016 year!

  • All fields are required to submit application.

    CHILD INFORMATION

  • PARENTS/GUARDIAN

  • EMERGENCY CONTACT (must fill out at least one emergency contact)

  • PAYMENT INFORMATION

  • Please read the terms and conditions below carefully! By checking the box, you confirm that you have read the terms and conditions and that you understand that you and the registrant will be bound by them:

    I, the undersigned, parent or legal guardian of the participant, a minor, hereby authorize the directors, leaders, or supervisors of the program acting in the capacity of activity supervisors as my agents to consent to medical and/or dental examination and/or treatment. If there is an emergency and I cannot be reached, please contact the emergency contact provided in my registration. In case of emergency and you are unable to reach me or the emergency contact I provided you, I hereby authorize treatment, and/or care at any hospital.

    I, the undersigned, parent or legal guardian of the participant, a minor, acknowledges that participation in athletic events necessarily involves risks of physical injury. I further acknowledge that the programs of ECRC and St. Thomas Chaldean Catholic Church are primarily administered by volunteers, rather than paid professionals. In consideration for accepting the registration of the named individual and permitting the voluntary of said individual in its programs, I hereby release, discharge, and hold harmless ECRC and St. Thomas Chaldean Catholic Church, its employees and other representatives from any claims arising out of or relating to any physical injury that may result to said individual while participating in an ECRC and St. Thomas Chaldean Catholic Church event, including any physical injury by the negligence of any official, referee or coach while performing his/her duties during any activities or games.

    I, the undersigned, parent or legal guardian of the participant, a minor, acknowledges that if my child is found to have been disturbing other children, volunteers or directors and has prohibited a volunteer, director or employee from doing their job or role in the program, that the child will be asked to leave and not return to the program. I recognize that the determination of what is defined to be as disturbing is held up to the directors of the program and will understand and recognize the say of the directors of the program. I recognize that the punishment for breaking any of these stated terms and conditions will result in removal of my child from the program without refund.

    We release the use of any photos / video taken during any events