VBS Registration Form

VBS Registration

Event Timing: June 22-24, 2026
Event Address: 719 US-62 Maysville, KY 41056
Contact us at 606-759-7211 or victorycc.office@gmail.com

Childs Name *

Childs Age *

Parents Name *

Address *

Phone Number *

Email *

What days will you attend? *

June 22

June 23

June 24

Allergies, Medications, and/or Medical Conditions

Emergency Contact * Name, Relationship, Phone number

People authorized to pick up my child Name, Relationship, Phone number

LIABILITY RELEASE: In consideration of VCC (Victory Christian Center) allowing the above child(ren) to participate in Vacation Bible School activities, I, the undersigned, do hereby release, forever discharge, and agree to hold harmless VCC Church, its directors, employees, volunteers, and agents (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 above child(ren) while involved in Vacation Bible School. Furthermore, on behalf of my minor child(ren), I hereby assume all risk of accidental personal injury, sickness, death, damage, and expense as a result of participation in activities involved therein. * I understand and have read the above Liability Release.

PHOTO/VIDEO PERMISSION: I Do/Do Not give my consent to VCC (Victory Christian Center) to use photo or video images taken of my child(ren) in church brochures, advertisements for the church, on the website, in social media, and in other church publications as they see fit. I agree to hold harmless VCC from any liability which may result from the use of said picture(s). This form will apply throughout my child(ren)’s tenure at Assumption VCC’s Vacation Bible School. **None of the photos will be for personal use.** I hereby give permission for my child(ren) to participate in Vacation Bible School at VCC Church on June 22-24, 2026

E-Signature *