Roar! VBS at Grace Episcopal Church
July 22nd-25th from 9am-noon
200 W. Lang Alvin, TX 77511
Contact us at (281) 331-5657 or office@gracechurchalvin.com
Email address *
Phone number *
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Paren'ts First Name *
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Paren'ts Last Name *
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Home Address *
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Child's First Name *
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Child's Last Name *
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Emergency contact name *
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Relationship to child *
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Emergency contact phone number *
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Name and phone number of person/s allowed to pick up this child from VBS *
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Grade entering Fall 2019 *
VBS will be four days. For planning purposes, please check any and all dates your child plans to attend. *
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Food allergies *
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Medical concerns (if none, please put "none") *
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Do you wish to purchase a t-shirt? Cost is $10. Link for payment will be sent to you shortly after completing and submitting this form. *
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If yes, t-shirt size (youth)?
If yes, t-shirt size (adult)?
I understand that reasonable precautions will be taken to safeguard the health and well being of the participants in this VBS and that I will be notified as soon as possible in the event of an emergency. By signing below, in the case of sickness or an accident, I authorize and consent the VBS Team, or other associated volunteers of the VBS program to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that myself or other legal guardian(s) cannot be reached. Any cost incurred shall be my sole responsibility. I hereby do release and forever discharge this church, VBS team, and other associated volunteers from all manners of actions, claims which I or the child named above shall or may have for any reason, arising during my child’s attendance of the VBS. Unless other written instruction is submitted, I also consent to allowing my child’s image to be recorded, either by photograph or video, and used during the VBS week or for future advertisement of Parish VBS programs. Any other use will require your further consent. Note that no names will be associated with the photos posted. *
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A copy of your responses will be emailed to the address you provided.
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