JIBC VBS 2026 Registration

Will NEED TRANSPORTATION

YES NO

Parent/Family General Information

Parent Name

Name

Email will be the PRIMARY source of communication we will have with your family. These emails will be related to VBS (or possibly AWANA) and will provide information you may need to know about. Please check yes or no in response to this information.

Yes No

This address will receive a confirmation email

We will never spam or send needless text messages. We will use text communication for weather-related closings and/or in the case of an emergency.

Yes No

Mother's Mobile

Father's Mobile

Address

How did you hear about VBS?

AWANA Friends Neighbors The Sign Facebook Other

Does your family attend church regularly?

Yes No

Medical Permission

As the parent/guardian of the child(ren) named, I do hereby authorize treatment of the child(ren) named on this form in the event of a medical emergency that may endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted ONLY after a reasonable effort has been made to reach me by phone at the number(s) listed above. I assume the responsibility of any cost connected with such treatment and hereby release Johnstown Independent Baptist Church, 7397 Johnstown-Alexandria Road, Johnstown, OH 43031, from any liability for any accident, injury, or costs that may occur. This release form is completed and accepted of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence.

Yes No

Media Permission

JIBC periodically receives attention from local newspapers about our AWANA and/or IMPACT programs. We ourselves take pictures of children and activities to use on our Facebook page, website, or occasionally a printed flyer. We need a legal guardian’s permission to do these things and ask you to respond to this information. If you choose not to grant permission, this will in no way affect any child’s opportunity to participate in programs or events. So that we can honor your wishes, mark the box indicating your choice. Please call if you have questions or concerns at 740.967.7417.

Yes No

Transportation Permission

I do hereby authorize member van drivers of JIBC to transport my child(ren), listed above, to and from AWANA, VBS, IMPACT and/or other children's ministries. I release Johnstown Independent Baptist Church, 7397 Johnstown-Alexandria Rd., Johnstown, Ohio, from any liability for accident or injury incurred from transportation in our church van or member vans.

Yes No

Child Registration

First Child

Name

Gender

Boy Girl

Grade going into

Birthdate(mm/dd/yyyy)

Important Medical Information such as ALLERGIES, Chronic Illness, or other condition

Second Child

Name

Gender Boy Girl

Grade going into

Birthdate(mm/dd/yyyy)

Important Medical Information such as ALLERGIES, Chronic Illness, or other condition

Third Child

Name

Gender Boy Girl

Grade going into

Birthdate(mm/dd/yyyy)

Important Medical Information such as ALLERGIES, Chronic Illness, or other condition

Fourth Child

Name

Gender Boy Girl

Grade going into

Birthdate(mm/dd/yyyy)

Important Medical Information such as ALLERGIES, Chronic Illness, or other condition

JIBC VBS 2026 Registration

Description

Please Fix the Following