Knotty Oak Baptist Church

Vacation Bible School Registration

Junkyard Redemption — God's Master Plan to Remake Our Broken World

August 3–8, 2026 | 9:00 AM – 12:15 PM | Ages 5 – Grade 12

Child Information

Child's Full Name *

Date of Birth *

Age

Grade (Fall 2026) *

Parent / Guardian Information

Parent / Guardian Name *

Home Address

Phone (Primary) *

Phone (Secondary)

Email Address *

Emergency Contact (if different from parent)

Emergency Contact Name

Relationship to Child

Phone Number

Medical / Allergy Information

Allergies (or write "None")

Medical Conditions or Special Needs

Permission & Liability Waiver

1. Participation & Liability Waiver

I give permission for my child to participate in all VBS activities at Knotty Oak Baptist Church, August 3–8, 2026. I understand that reasonable care will be taken, and I release Knotty Oak Baptist Church and its staff from liability for any injury that may occur during the program.

I agree to the Participation & Liability Waiver above. *

Parent / Guardian Signature *

Date *

2. Photo & Media Permission

I give permission for photos and/or videos of my child to be taken during VBS activities and used in Knotty Oak Baptist Church publications, bulletins, social media, and other church communications.

I give permission for photos/videos of my child to be used as described above.

Parent / Guardian Signature

Date

Questions? Call 401-226-5856 or email jmart2cor515@gmail.com
11 Knotty Oak Road, Coventry, RI