June 4 - 8, 2018

Age 4 years by June 4th

through entering the 5th grade

 

purpose church "farm" property

9993 weLD county road 11

firestone, co 80504

corner of silver birch & sable

MONday - Thursday

begins at 9:00 a.m.   ends at 11:30 a.m.

friday family night begins at 5:30 p.m.

APPLICATION

Required fields have an asterisk (*)

PHOTOS WILL BE USED FOR A SLIDESHOW SHOW AT CHURCH ON SUNDAY AND WILL NOT BE POSTED ON THE INTERNET.  

Photo Permission*
Do you have a home church?*

Your child(ren) must be signed-in and signed-out by an adult each day.  If this adult will not be you, please indicate others that are authorized to do so.

Purpose Church VBS Liability Waiver 2018 

 

As the parent or legal guardian of

 

 

 

 

 

 

I hereby give permission for my child to participate in the Purpose Church VBS Program. I understand that Purpose Church is a nonprofit charitable institution, which is voluntarily presenting this program for my child, other participants, and the community. I also understand that the program has activities that can involve physical contact with other participants, the ground or equipment, and that there is a resulting risk of physical injury to my child.

 

I have explained these risks and the benefits of participating in this program to my child and my child is in proper physical condition and has no existing injuries or conditions that could jeopardize his/her safety or health, or the safety or health of the other participants.

 

Additionally, I recognize that every effort has been made to accommodate any food allergies I have reported for my child during snack at VBS and that they will be handled to the best of the abilities of the volunteers and staff of Purpose Church VBS and that all reasonable precautions will be taken to avoid allergen contaminants in food my child consumes from Purpose Church.  I will not hold Purpose Church, their volunteers, or staff responsible for any contact or injury from food allergens, up to and including those resulting in death, that may be caused by my child receiving or consuming any food that comes from VBS.

 

I therefore release and discharge all liability for any harm or injury suffered directly or indirectly as a result of my child's participation in Purpose Church VBS Program, whether or not resulting from negligence, and I agree not to sue Purpose Church, its representatives, staff, or volunteers on any such claim. I also give permission for the staff, representative, or volunteers of Purpose Church to administer first aid or to seek medical care for my child during my child's participation in the program, including transportation of my child to a medical facility for additional treatment that appears necessary.

 

Name of Parent/Guardian:

Date: 

Our missions outreach this year consists of non-perishable food items for the Carbon Valley help Center.  please consider donating if you are able.

A $5 donation is requested per T-Shirt when you arrive

please indicate The grade your child will be entering into in the fall.  Available for Age 4 by june 4th through entrance into 5th grade
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Hello from purpose church will be in contact with you to confirm your application within 72 hours.

©2016 Purpose Church. All Rights Reserved  |  9993 County Road 11  Firestone, CO  80504  |  (303) 651-1640  |  hello@purpose.church

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