Vacation Bible School 2019

Please Note:  Statement of Consent, Medical Release and Photo Release MUST be approved by you.

Tuition is FREE for volunteer's children.
Please contact Lidia Rojas at lrojas@hfnovi.com before registering if you are interested in volunteering.

Registration Information
June 24-28, 2019 9:00AM - Noon
Parent(s) Name
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E-mail
Father's Phone --
Mother's Phone --
Emergency Contact
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Emergency Contact Phone -- ext
Emergency Contact Relationship
First Student's Name
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Age
Grade Completed
Special Needs/Allergies/Comments Enter NONE if there are none.
Second Student's Name
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Age
Grade Completed
Special Needs/Allergies/Comments Enter NONE if there are none.
Third Student's Name
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Age
Grade Completed
Special Needs/Allergies/Comments Enter NONE if there are none
Statement of Consent
Consent to Participate If you would like your child to participate in this event, please complete and sign the following statement of consent and release of liability. As parent or legal guardian, you remain fully responsible for the actions and conduct of your child.
STATEMENT OF CONSENT I hereby consent to participation by my child(ren), listed in this application in Holy Family’s 2019 Vacation Bible School. I understand this event will take place on parish grounds and my child(ren) will be under the supervision of the designated parish employee on the stated dates. I further consent to the conditions stated above on participation in this event. In consideration of my child(ren) being allowed to participate in this event, I hereby agree on behalf of myself, and my child, to release the Church of the Holy Family, the Catholic Archdiocese of Detroit, and any and all affiliated organizations, their employees, agents, and representatives, including volunteers (collectively “Releasees”), from any and all claims, including negligence, which may be asserted by me or my child(ren), or on behalf of my child(ren) arising from or relating to my child(ren)’s participation in the event. In the event this release on behalf of myself and/or my child(ren) is held to be invalid or unenforceable, I hereby agree to indemnify and hold harmless Releasees from any and all claims, including negligence, which may be asserted by me or my child(ren), or on behalf of my child(ren) arising from or relating to my child(ren)’s participation in the event. This release of indemnification does not apply to the extent of commercial insurance coverage for any claim, but this Release of Indemnification shall apply to the extent of any self-insurance or deductible applicable to any claim.
Parent/Guardian Approval Fill in your name as your APPROVAL
Date //
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MEDICAL RELEASE In the event of an emergency where medical treatment is required, I give my permission to the church staff or sponsor to obtain the services of a licensed physician. Please attempt to notify me immediately concerning any such emergency.
Parent/Guardian Approval
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Fill in your name as your APPROVAL
Date //
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PHOTO RELEASE Allows Holy Family to take and use images of your child in the VBS programs
Parent/Guardian Approval
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Fill in your name as your APPROVAL
Date //
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Payment
Shopping Basket  
Quantity Extended

$30 Per Child | $30.00

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Order Summary
Subtotal
Discount
Sales Tax
Shipping & Handling
Total

Payment Type

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