VBS 2024 VBS with Me Registration

Parent Name

This address will receive a confirmation email

Parent 1 Cell

Home Phone

Child's Name

What days will this child be attending? Check all that apply.

Monday Tuesday Wednesday Thursday Friday

Child's Birthdate

Child's Age

Child's T-Shirt Size

Name of Adult participating with the child:

Relationship to the child?

Does the adult want to purchase a t-shirt? Yes No

If yes, what size?

Allergies

Child - List any food allergies for the child.

Does the Child have an EpiPen with them?

Adult - List any food allergies for the adult.

Does the adult have an EpiPen with them? Yes No

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.

 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.

Emergency Contact: Please list the name, phone number and relationship for an emergency contact.

Payment

Payment can be made in person or by mail with cash or check, or via credit card here. Please choose the appropriate option. An optional donation for the healthy snack fund is appreciated but not required.
June 2 or earlier- Discounted rate of $30 for the first child and $25 for each additional child with a max of $100 for the household.
June 3 or later - Full amount of $35 for the first child and $30 for each additional child,with a max of $120 for the household.

When paying by credit card there is an additional fee, as shown below.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

June 17-21, 2024, 9:00am - 12:00pm

Children younger than 3 years of age or 3-4 year olds who are either not potty trained or are not used to a school environment are welcome to attend VBS with an adult (parent, grandparent, sitter, etc.) participating alongside them. Adults may purchase a shirt for $10 if they so choose.

This “VBS with Me” group of young children and their participating adults will rotate to the Bible Story, Games, Art, Music, and Snack activities. The Nursery room is available at anytime for quiet time, diaper changes, or nursing/bottle feeding as needed and directed by the participating adult.

REGISTRATION FEES – SAVE BY REGISTERING EARLY!
Payment can be made in person or by mail with cash or check, or via credit card here at the bottom of this form. When paying by credit card there is a small additional fee.

June 2 or earlier- Discounted rate of $30 for the first child and $25 for each additional child with a max of $100 for the household.

June 3 or later - Full amount of $35 for the first child and $30 for each additional child, with a max of $120 for the household.

Additional snack donations are appreciated! You can add any amount onto the fee to help support our healthy snack fund. If you have other children signed up for traditional VBS, feel free to add your child(ren) for VBS with Me at the discounted rate using the write in price option.

Confidential scholarships are available from Becky Mosher at wpcbeckym@gmail.com or 847-223-0073.

VBS 2024 VBS with Me Registration

Description

Please Fix the Following