Complete the form below to register up to two children:
Please Note: When you drop off your child on their first night of VBS we will ask you to sign the statement below,
I, parent/legal guardian of the child(ren) listed above, do give my permission for said child(ren) to participate at Daniels Road Baptist Church during this event. If my child(ren) has medical conditions that may be relevant to a physician in the event of emergency, I have listed them above. If I cannot be reached at the above phone number(s), I hereby authorize medical personnel selected by Pastor Mike Banks or other DRBC adult sponsors to make emergency medical decisions for my child(ren). I understand and hereby agree to assume all of the risks that may be encountered on said activity. I will not hold DRBC, its leaders or directors liable for an accident resulting from attending Vacation Bible School. I expressly agree that this release, waiver and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Florida. I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act.
Parent Signature: ________________________________________________________________