Unity Lutheran Church of Berwyn VBS
Registration for Vacation Bible School July 5, 6, and 7 from 1pm to 4:00pm
Child First Name
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Child Last Name
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Child Age
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Grade just completed
Parent/Gaurdian First Name
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Parent/Gaurdian Last Name
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Address
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City
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State
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Zip Code
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Allergies
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Medical Condition/Learning Disability
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Additional Information to share about your child
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Contact Phone
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Contact email
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Who may pick up your child from VBS?
We may request ID
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Emergency Contact First Name
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Emergency Contact Last Name
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Emergency Contact Relationship
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Emergency Contact Phone
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Are you able to help with VBS?
Release
As a legal guardian of the minor named above, I hereby confirm that I have chosen for this minor to participate in the Unity Lutheran Church of Berwyn Vacation Bible School program, including all planned and arranged activities. I am aware that this program may present risks of personal injury, property loss, or damage to participants. I accept all responsibility for any injury, death, or other loss or damage that may occur to me and/or to the minor as a result of the minor’s participation in the Unity Lutheran Church of Berwyn Vacation Bible School program. I release Unity Lutheran Church of Berwyn and will indemnify and hold harmless Unity Lutheran Church of Berwyn, its agents, affiliates, and successors from all claims, judgments, and costs, including attorney’s fees, incurred in connection with any action that may be brought as a result of the minor’s participation in the Unity Lutheran Church of Berwyn Vacation Bible School program. I have read the Agreement and Release of Liability. I understand and agree to the terms.
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