2019 VBS Registration

Mission Covenant Church 201 Vacation Bible School

(Month/Date/Year - Ex: 12/25/0000)

In the event that I cannot be reached regarding an emergency involving the above named child, I hereby give my permission: 1) To the VBS director to obtain emergency transportation as needed. 2) To the designated physician to provide any and all medically necessary treatment to include but not limited to: Injects, hospitalization, anesthesia, or surgery.

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