Download EAST BAY ALLIANCE CHURCH – VACATION BIBLE SCHOOL

EAST BAY ALLIANCE CHURCH – VACATION BIBLE SCHOOL
Emergency Contact & Medical Information
Child’s Name: _____________________________________________________________
Primary Emergency Contact: __________________________________________________
Primary Tele #: _________________________
Relationship to Child: _______________
Secondary Emergency Contact: ________________________________________________
Secondary Tele #: _______________________
Relationship to Child: _______________
Child’s Special Needs/Allergies: ________________________________________________
Consent, Terms, & Conditions
1.I give my consent for my child to participate in all activities associated with Vacation Bible School
(VBS) at East Bay Alliance Church (EBAC).
2.My child has my permission to receive rides from EBAC staff and the chartered bus company to
scheduled fieldtrips.
3.My child will secure his/her own valuables. EBAC is not responsible for lost/stolen valuables.
4.I give permission to EBAC to (a) photograph, film, or make sound recordings of my child, (b) to
quote or publish statements of my child, and (c) to use such photographs, videos, sound recordings
or written statements in connection with any publication and in such manner as determined by EBAC.
5.I voluntarily assume all risks on behalf of my child and I agree to release EBAC from any and all
liabilities and claims arising out of ordinary negligence in connection with child’s participation in VBS.
Parent Signature ______________________________________ Date ________________
Camping Trip Details (last day to sign up is Wednesday 6/21)
Date: 6/29 – 6/30 Thursday – Friday
Location: Chabot Regional Park (cost included in registration fee)
Activities: light hiking, BBQ, exploring, campfire…
Sleeping Arrangements: Groups of 4-6 same gender campers will be in a tent with a staff member
or a parent chaperone
Food: Main dishes will be provided, parents can sign up to bring “sides”, drinks, snacks
What to Bring: a list will be given out