VBS 2025 Childcare Registration

Parent Name

Where will you be during VBS (if known)

What days will you be at VBS? Check all that apply.

Monday Tuesday Wednesday Thursday Friday All

This address will receive a confirmation email

Parent 1 Cell

Home Phone

Child's Name

Child's Birthdate

Child's Age

Would you like to purchase a t-shirt for the child?

Yes No

If yes, what size?

Sleeping/Comfort

Does the child take a morning nap?

If yes, what time? From when to when?

Does your child sleep with a special blanket or pacifier?

Other special instructions about your child's sleeping pattern? PLEASE NOTE: Your child will be placed on his/her back unless otherwise instructed.

What soothes him/her when upset?

Feeding

Feeding: Check all that apply

Bottle Sippy cup Regular cup Water Goldfish Crackers VBS Snack of the day

Please list any food allergies or restrictions. Please write none if none.

Does this child have an EpiPen?

Yes No

Special feeding instructions?

Changing

Diapers:

Any special diapering instructions?

Please list the names of all people who may pick up your child from the Nursery/Child Care room

Any Additional Comments?

Parent/Guardian- please read the following and initial in the boxes if you agree.

 In the event of an emergency where medical treatment is required, I give my permission to the church staff or sponsor to obtain the services of a licensed physician. Please attempt to notify me or my emergency contact immediately concerning any such emergency. I release Wildwood Presbyterian Church from liability regarding any such injury or illness.

Yes

 Pictures or video of groups of children/volunteers having fun at VBS may appear on the church's website or on social media (i.e. church’s Facebook or Instagram page), without names attached to the children. I grant permission for you to photograph/videotape my child. Specific privacy issues will be addressed by special request.

I do grant permision. I don't grant permission.

Payment

No payment is required, however you may choose to purchase a tshirt and/or contribute to our healthy snack fund which is optional, but helpful.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

VBS 2025 Childcare Registration

Description

Please Fix the Following