Vacation Bible School
June 25 - 29       9 am - 12 Noon

Ages 3 year - 6th grade
(must be potty trained)

 

VBS Resgistration
Child's Information

Parent/Caregiver Information

Emergency Contact

Medical Release Statement

I (we), the undersigned parent(s) or guardian(s) of the child listed above, a minor, do hereby authorize adult volunteers of First Presbyterian Church Rome, GA, as agent(s) for the undersigned, to consent to any medical or surgical care deemed advisable by any accredited physician or surgeon in an approved emergency clinic or hospital.  I further release from any liability, First Presbyterian Church Rome, GA and any of its ministries or leaders in the event of an accident in route, during, and returning from the above mentioned event.

By entering your name you agree to the statement listed above.

I (We) also give permission for my child's pictures to be published on the church website and in house. *

Insurance Information