Thank You, we have received your form.
  • Child's grade for the 2024-2025 school year

  • My child will attend VBS on the following days...

    It is OK if plans change!

  • Parent/Guardian First & Last Name

  • Mobile Phone

  • Email

  • If Parent/Guardian cannnot be reached

    Emergency Contact First & Last Name

  • Emergency Contact Mobile Phone

  • Emergency Contact Email

  • Relationship To Child

  • Does your child have any allergies or snack time food restrictions (please list)?


    I hereby authorize and consent to the use of images or video of my child/children listed on this registration, with or without their name(s), by Lowell First Church of the Nazarene of Lowell, MA for purposes including but not limited to: promotional materials, printed publications, internet posts including social media, television, and other media sources.


    I do this with full knowledge and consent and waive all claims for compensation for use or for damages. I release Lowell First Church of the Nazarene, its officers, trustees, employees, and agents from liability for any claims by me or any third party in connection with the use of the image of my child/children listed on this registration.


    I, the parent/guardian of this registered child hereby give permission for him/her to participate in Vacation Bible School at Lowell First Church of the Nazarene. I consent to his/her participation in the activities planned for this event and certify that he/she is physically able to engage in the event. I hereby grant to the leader in charge of the group the right to make emergency medical decisions for my child in the event I cannot be reached. I understand I/we release and forever discharge Lowell First Church of the Nazarene, its staff and adult chaperones from any and all claims, demands, actions, or causes of action, past, present or future arising out of any damage or injury while participating in this event. I am at least 18 years of age, I understand the above statement and am competent and to execute this agreement.

  • Clear Signature