2018 VBS Registration - SHiPWRECKED VBS Aug 6-9 at First Pres Church
please complete this registration on or before Aug 1 - VBS is for 4 year olds thru completed 5th graders - a SHiPWRECKEDl VBS program will be held for preschoolers in our childcare setting for volunteers' kids
SHiPWRECKED VBS Aug 6-9
Mother's Name
Your answer
Mother's email
Your answer
Mother's address
Your answer
Mother's home phone
Your answer
Mother's cell phone
Your answer
Father's name
Your answer
Father's email
Your answer
Father's address
Your answer
Father's home phone
Your answer
Father's cell phone
Your answer
Parents' preferred method of contact during VBS
*Please note that we will send out important VBS updates via email. If you are unable to regularly check email, please let us know and we will phone or text you instead.
Your answer
1st child's preferred name
Your answer
1st child's birth date
Your answer
1st child's age
Your answer
1st child's Fall 2018 school grade
Your answer
1st child's allergies, medical conditions, physical restrictions, anything else we should know
Your answer
2nd child's preferred name
Your answer
2nd child's birth date
Your answer
2nd child's age
Your answer
2nd child's Fall 2018 school grade
Your answer
2nd child's allergies, medical conditions, physical restrictions, anything else we should know
Your answer
3rd child's preferred name
Your answer
3rd child's birth date
Your answer
3rd child's age
Your answer
3rd child's Fall 2018 school grade
Your answer
3rd child's allergies, medical conditions, physical restrictions, anything else we should know
Your answer
4th child's preferred name
Your answer
4th child's birth date
Your answer
4th child's Fall 2018 school grade
Your answer
4th child's allergies, medical conditions, physical restrictions, anything else we should know
Your answer
Emergency Contact name
Your answer
Emergency Contact relationship to child
Your answer
Emergency Contact home phone
Your answer
Emergency Contact work phone
Your answer
Emergency Contact cell phone
Your answer
Name of family doctor for child(ren)
Your answer
Family doctor's phone number
Your answer
Name of family dentist for child(ren)
Your answer
Family dentist's phone number
Your answer
Name of health insurance company
Your answer
Policy number
Your answer
Group number
Your answer
Name of insured
Your answer
Participation Consent and Release Form *
By checking the "yes" box below, I am giving permission for my son(s)/daughter(s) to participate in VBS at First Presbyterian Church. I understand that though First Presbyterian Church and leaders of VBS have safety as their goal, some activities may involve risk of personal injury and/or property damage or loss of person or property. And, I hereby waive and release all claims or rights against First Presbyterian Church, its officers, directors, coordinators, adult leaders, and all owners of equipment which may be used in this event for any and all injury, damage or loss of personal property incurred during this event. I understand that all participants are expected to conduct themselves in an appropriate manner and to obey the leaders. I understand that I will be contacted as soon as possible concerning any medical or behavioral problem with my child. I give my permission for, and will accept financial responsibility for VBS leaders to act in my behalf in the event of a medical emergency for my son/daughter.
Your answer
Photo Release *
Children are not identified by name in any published photo, unless special, separate consent is given. I give permission for my child's photo to be printed in the First Presbyterian Church newsletter, or on the church's website (www.firstpreswilson.com) or Facebook page.
today's date
Your answer
Volunteer PLEASE! Parents, grandparents, teens, and caregivers are encouraged to volunteer with VBS one or all the days of VBS. Training and instruction are provided.
Tell us which day(s) we can count on your help - check all that apply. While volunteering, your preschool children will enjoy our preschool version of HERO Central VBS in our childcare area!
Tell us your preference for where you would like to volunteer - check all that apply
if you cannot help VBS weekdays, tell us when you'd rather support the fun of VBS!
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