PGBC VBS Pre-Registration Parent and/or Guardian InformationName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email Child InformationHow many children will attend?*1234Name*NicknameAgeAllergiesName*NicknameAgeAllergiesName*NicknameAgeAllergiesName*NicknameAgeAllergies* I have read and agree to the Terms and Conditions stated below.Terms & Conditions 1. I understand that my child(ren) may participate in physical activities such as those held during Game Time. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from any liability, Pleasant Grove Bible Church and any persons involved in the VBS ministry. 2. In the event of an emergency that requires medical treatment for the above named child(ren), I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give permission to the VBS volunteers to secure the services of a licensed physician to provide the care necessary for my child's well-being. I assume responsibility for all costs connected to any accident or treatment of my child. I have read and agree to the Terms and Conditions stated above.