Vacation Bible School

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Vacation Bible School Registration Form

August 1st-5th 9:00 a.m. to 3:00 p.m. (Mon.-Thu.) & 9:00 a.m. to Noon (Fri.)

Day

Hour

Minute

Second

Please register as soon as possible.
$35.00 Registration fee for the first child and $30.00 for each additional child (This fee covers all crafts and snacks, and must be paid at the time of registration). You may send a check written to Holy Cross Lutheran Church (VBS in Memo Line) or after submitting this form, please click on the "Giving" page, fill out the form and in the drop down menu select Vacation Bible School Fees.
Please have family friends fill out a separate registration form so that we may get individualized health information and a parent's "signature" on the registration form.
Kids will be grouped based on their upcoming school year, beginning with Kindergarten.
All campers will need to bring their own sack lunch and a bottle of water. Morning snacks will be provided.

Child's Name(Required)

Male

Female

Upcoming Grade(Required)

Child's Name

Male

Female

Upcoming Grade

Child's Name

Male

Female

Upcoming Grade

Home Church

Parent/Guardian Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

City(Required)

State(Required)

Zip Code(Required)

Contact Phone Number(Required)

Secondary Emergency Contact Name(Required)

Secondary Emergency Phone Number(Required)

Secondary Emergency Contact Relationship to Child(Required)

I Am Permitting The Following Individual(s) To Pick Up/Drop Off My Child(ren) from Holy Cross (PLEASE TYPE NAME OR N/A)(Required)

Name of Child(ren)'s Physician(Required)

Phone Number(Required)

Do You Carry Health Insurance?(Required)

Yes

If Yes, The Provider Is

Group/Policy Number

Please List Any Specific Health Concerns (ex: Asthma, Food & Other Allergies, Insect Allergies, Medical Conditions, etc.)

Will Your Child Take Medications While At VBS(Required)

Yes

All medications will need to be given to the VBS Director at the beginning of the day and may be picked up at the end of each day. All prescribed medications must be in the camper's name ONLY.

Activities Your Child Should AVOID?

Games

Snacks

Crafts

Other

Any Further Special Instructions?

Media Agreement(Required)

Photographs or video may be taken of your child during camp, only to be used by Holy Cross. No names will be attached. Check the box if you agree or disagree and type name in box.

(Required)

Agree

Disagree

By typing your name above, you state that your child(ren) has(have) permission to participate in all activities except as noted above. I agree that Rainbow Trail or Holy Cross Lutheran Church will not be held responsible for accidents or persons injured arising there from. I hereby give permission to the medical personnel selected by the directors to order treatment and/or provide emergency transportation for my child in the event that I cannot be reached.(Required)

Date(Required)