Child's Name *
Child's Name
Parent/Guardian Name *
Parent/Guardian Name
Use of Image Authorization *
I, the parent/guardian of the child listed above give Asbury United Methodist Church my permission to use my child’s/children’s photo/video images on their website & in other church and outside publications.
Medical Authorization *
I, the parent/guardian give Asbury United Methodist Church my permission to seek emergency medical treatment for my child during the week of July 22 - 26, 2019.
Please note if your child is carrying an EpiPen, Inhaler, etc. with them to VBS and any information we should know about it.