Media Release Form

Cross of Life Lutheran Church (COL) occasionally uses photographs, videos, and audio recordings of members and events in its publications, in the local press, on its website, and in social media. Signing this release form grants COL permission to use your and/or your child's image and/or voice recording in its publications and other media outlets. Images and voices will not be identified by name. This form supersedes previous release forms.

I hereby grant permission to Cross of Life Lutheran Church to use my image and/or voice in printed publications, on its website, and in social media without further consideration, and I acknowledge that COL and local press have the right to crop or treat the photography, video, or audio recordings at their own discretion. I also acknowledge that COL may not choose to use the media at this time, but may do so at its own discretion at a later date. I also understand that once my image or voice is posted on the internet, the media can be downloaded. Therefore, I agree to indemnify and hold harmless from any claims the following:

- All members of Cross of Life Lutheran Church
- All employees of Cross of Life Lutheran Church

Cross of Life Lutheran Church reserves the right to discontinue use of photos, videos, and/or audio recordings without notice.

Note: * indicates required fields. Please do not use "autofill" when filling out this form.
NAME*

ADDRESS*

EMAIL ADDRESS*

TELEPHONE*

I hereby grant permission to Cross of Life Lutheran Church of Roswell, GA to use:

Photographs*
—Please choose an option—YesNo

Videos*
—Please choose an option—YesNo

Audio recordings*
—Please choose an option—YesNo

For my minor children as listed below, I grant permission to Cross of Life Lutheran Church of Roswell, GA to use:

Photographs
—Please choose an option—YesNo

Videos
—Please choose an option—YesNo

Audio recordings
—Please choose an option—YesNo

Names of minor children

Revised 3-28-2018

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Welcome to Vacation Bible School! This form is for registering children 3 years old through 5th grade. If you have questions about our program or would like to volunteer, contact the VBS director Roel at ministrycoordinator @ crossoflifelutheran.org. We ask that you register by Friday, May 31 so we have time to prepare for your child’s VBS experience.
 
 

*indicates required field

Family Name*

First Child's Name*

First Child's Age*
—Please choose an option—34567891011

First Child's Birthdate*

Last grade completed*

—Please choose an option—PreschoolKindergartenFirstSecondThirdFourthFifth

Allergies

Health concerns

Second Child's Name

Child's Age

—Please choose an option—34567891011

Child's Birthdate

Last grade completed

—Please choose an option—PreschoolKindergartenFirstSecondThirdFourthFifth

Allergies

Health concerns

Third Child's Name

Child's Age

—Please choose an option—34567891011

Child's Birthdate

Last grade completed

—Please choose an option—PreschoolKindergartenFirstSecondThirdFourthFifth

Allergies

Health concerns

Fourth Child's Name

Child's Age

—Please choose an option—34567891011

Child's Birthdate

Last grade completed

—Please choose an option—PreschoolKindergartenFirstSecondThirdFourthFifth

Allergies

Health concerns

Parent/Guardian's Full Name*

Second Parent/Guardian's Full Name

Best Contact Email*

Best Contact Number*

Alternate Phone Number

Home Address*

 
Street Address

City

State

Zipcode


Checkout authorization

At check-out, we can only release children to a parent/guardian listed above, unless we have specific permission. Would you like to authorize anyone else to pick up your child(ren)?

Emergency Contact*
 

Name of Contact*

Emergency Contact Phone Number*

Emergency Contact Relationship to Child*

Media Release: If you have not previously completed a media release form, please fill out the online media release form or print and complete a media release form from the previous page and include it you when you submit your registration to the office.

Parents and Caregivers, we have many opportunities for you to support this volunteer-run event. If you would like to contribute, please indicate your choice(s) below, and we will contact you with details. We always work to find the best fit for your gifts and interests. If you volunteer to work with children, you will need to complete a background check.

Volunteer in the kitchenVolunteer to lead kids' groupDonate through Amazon listInvite friends

Donations: VBS is a free program of Cross of Life, but donations are appreciated. A suggested donation is $10 per child, with a max of $25 per family. If you choose to donate, you may bring cash or a check the first evening or give online through our website at https://crossoflifelutheran.org/give/. Checks can be made out to Cross of Life with "VBS" in the memo line. Your donation is tax deductible. Thank you!

NEW THIS YEAR! Georgia Aquarium Trip
We will take a trip to the Georgia Aquarium on Saturday, June 8 at 10AM. We need 15 people to make this trip and the cost will be around $35 per person, with kids 2 and under going for free. Please let us know if you are interested.

Here's how many of us will be going!

—Please choose an option—012345678910
 
 

Your form will be submitted to the VBS registrar. You should receive a confirmation email shortly. We can't wait to see you at VBS!

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