SALC VBS 2021

St. Andrew Lutheran Church

Vacation Bible School

June 28th-July 2nd; 9:00am to 12:00pm

Registration is full for in-person VBS. Space is currently limited to 40 participants for in-person registration. Online version of VBS is available for unlimited numbers.

If you wish to be put on a wait list in case of a cancellation or a possibly improvement of county health and loosened restrictions, fill out the registration page without submitting a donation. *Note that submitting your online registration does not sign you up for in-person VBS but puts you on a wait list.

Once your registration is received, you will receive a follow-up email from the VBS director to confirm the option of wait list or online VBS.

In-person VBS will be structured as an outdoor program. We will be following the guidance from the Washington State Dept. of Health for childcare and day camps.

Supplies, videos and other resources will be made available for those choosing the online version.

Parent/Guardian

Parent/Guardian Name

Primary Phone

Secondary Phone

Address

Emergency Contact

Phone Number

Relationship

Additional Pick-up Person (if different)

Phone

Relationship

Registration Preference

Number of children to register

Home Congregation (if any)

Enter the name, grade and other information below for each child being registered (maximum 5 on this form).

Child 1

Child 1 Name

Child 1 Gender

Child 1 Date of Birth (must be at least 4 yrs old at time of VBS)

Child 1 Grade in fall 2021

Child 1 Physical or Other Restrictions

Child 1 Allergies & Medications

Child 1 T-Shirt Size

Child 2

Child 2 Name

Child 2 Gender

Child 2 Date of Birth (must be at least 4yrs old at time of VBS)

Child 2 Grade in fall 2021

Child 2 Allergies & Medications

Child 2 Physical or Other Restrictions

Child 2 T-Shirt Size

Child 3

Child 3 Name

Child 3 Gender

Child 3 Date of Birth (must be at least 4yrs old at time of VBS)

Child 3 Grade in fall 2021

Child 3 Allergies & Medications

Child 3 Physical or Other Restrictions

Child 3 T-Shirt Size

Child 4

Child 4 Name

Child 4 Gender

Child 4 Date of Birth (must be at least 4yrs old at time of VBS)

Child 4 Grade in fall 2021

Child 4 Physical or Other Restrictions

Child 4 Allergies & Medications

Child 4 T-Shirt Size

Child 5

Child 5 Name

Child 5 Gender

Child 5 Date of Birth (must be at least 4yrs old at time of VBS)

Child 5 Grade in fall 2021

Child 5 Allergies & Medications

Child 5 Physical or Other Restrictions

Child 5 T-Shirt Size

To help cover costs, suggested donation is $20 per child, $50 per family.

Donation Amount

I give permission for my child/children to be photographed/videotaped in Vacation Bible School and to use these pictures in church publications, on the church website, and/or for congregational presentations.

Photo Consent

Medical Release

I hereby release St. Andrew Lutheran Congregation, its staff, and volunteer leaders from all responsibility and liability for any injury or illness that my child/children may sustain during Vacation Bible School. In the event of an emergency, I hereby authorize an adult leader of the activity, as an agent for me, to consent to any medical or dental examination and diagnosis as advised by a licensed medical practitioner. I/we will assume financial responsibility for any and all medical procedures performed with consent of the agent of St. Andrew Lutheran Church. I will be contacted as soon as possible regarding the medical emergency.

I have read and agree to the terms above.

Total

$0.00

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