Vacation Bible School Participant Registration

Please fill out one form per participant.

Participant Information


Will your child be joining us virtually or in person?

Parent/Guardian Information


Medical Information

Emergency Contact (Name and Number)

Media Release

Our Media Release is as follows: I, the undersigned, on behalf of myself of my child do hereby grant permission to King’s Grant Presbyterian Church (KGPC) and its designees permission to photograph, broadcast, or video my child during KGPC sponsored activities. I hereby grant KGPC permission to use my child’s likeness in photography, videos, motion pictures, sound recording, broadcasts, quotes, testimonies, stories, or any combination thereof, to be released for public viewing and/or hearing, or a combination of the same, through public mass media or through KGPC's publications or presentation throughout the world and forever. I waive any right to review or approve any works created, including written or electronic copy, wherein my child’s likeness appears. I understand and agree that these materials will become the property KGPC. I understand that my child will not be identified by name unless I give my express permission. In addition, I waive any right to royalties or other compensation arising or related to the use of photographs, videos, broadcasts, wherein my child’s likeness appears. I hereby agree to release, defend, and hold harmless KGPC, its directors, officers, trustees, employees, volunteers, agents, contractors, successors, and assigns from any and all claims that I may have now or in the future relating to this Release however arising, including but not limited to, invasions of privacy, right of publicity, trademark infringement, copyright infringement, or defamation. I have read this release before signing below, and I fully understand the contents, meaning, and effect of this Release.

*Please check the appropriate box

Liability Release

PARENTAL CONSENT The undersigned does hereby give permission for my child to attend and participate in any KGPC children/youth ministry activities, events, retreats and childcare. LIABILITY RELEASE: In consideration of KGPC allowing the Participant to participate in children/youth ministry and childcare, I, the undersigned, do hereby release, forever discharge and agree to hold harmless KGPC, its pastors, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the children/youth activities. I the parent or legal guardian of this Participant hereby grant my permission for the Participant to participate fully in children/youth ministry activities, including trips away from the church premises. Furthermore, I, on behalf of my minor Participant, hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. The undersigned further hereby agrees to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto.


Additional Information

745 Little Neck Rd. 
Virginia Beach, VA 23452