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VBS at Golden Springs is June 10th-13th, 8:30am-12:30PM.
Family Night will be June 13th in the evening.
More details to come.

Please register one child at a time below.

MUST BE SUBMITTED BY 11:59 p.m. on JUNE 5th, 2019!

Child's Name *
Child's Name
Parent/Guardian's Name *
Parent/Guardian's Name
Address *
Address
Home Phone Number
Home Phone Number
Parent/Guardian Cell Phone Number *
Parent/Guardian Cell Phone Number
Parent/Guardian Work Phone Number
Parent/Guardian Work Phone Number
In case of emergency, whom do we call? (Primary) *
In case of emergency, whom do we call? (Primary)
In case of emergency, whom do we call? (Primary) (Phone Number) *
In case of emergency, whom do we call? (Primary) (Phone Number)
In case of emergency, whom do we call? (Secondary)
In case of emergency, whom do we call? (Secondary)
In case of emergency, whom do we call? (Secondary) (Phone Number)
In case of emergency, whom do we call? (Secondary) (Phone Number)
Child's Date of Birth (Must be 4 years old by 9/1/2019) *
Child's Date of Birth (Must be 4 years old by 9/1/2019)
Last Grade Completed *
Who may pick up your child at the end of each VBS day? *
Who may pick up your child at the end of each VBS day?
YOU WILL RECEIVE BY EMAIL AND WILL HAVE TO HAVE A SECURITY CODE TO PICK UP YOUR CHILD
Who may pick up your child at the end of each VBS day? (Second-Optional)
Who may pick up your child at the end of each VBS day? (Second-Optional)
Who may pick up your child at the end of each VBS day? (Third-Optional)
Who may pick up your child at the end of each VBS day? (Third-Optional)
Terms and Conditions
I hereby authorize Golden Springs Baptist to record and photograph (on film, tape, digital, electronic or otherwise) me or my child and to record his or her voice during their participation in the Event. I hereby further authorize and agree to Golden Springs Baptist’s unrestricted use, reuse and distribution of said images and recordings, in whole or in part, whether in the original or modified form, in any manner or media, including, without limitation, for purposes of advertising, promoting and publicizing the Event, during the Event or at any time thereafter, in the sole and absolute discretion of Golden Springs Baptist, both in the United States and internationally. I expressly and irrevocably waive any and all rights I might otherwise have, now or in the future, to any related privacy or intellectual property rights, proceeds, benefits or similar claims of any kind. I hereby release and discharge Golden Springs Baptist (as defined herein above) its officers, employees, staff, sponsors, affiliates, licensees, vendors, and all others who may participate in the planning, organization, production, presentation, and implementation of the Event, individually and collectively, from and against any and all claims, demands, or causes of action that I may now or hereafter have in connection with or in any way related to the use and exercise of the rights granted in this release and consent. *
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