Vacation Bible School Registration 2023 Please enable JavaScript in your browser to complete this form.Child's Name *FirstLastBirthdate *Child's gender *MaleFemaleChild's Grade (current 2022-2023 school year) *Pre-k (Because we will be outside this year, our 3 and 4 year olds need to be accompanied by a teen or adult "shepherd")Kindergarten1st grade2nd grade3rd grade4th grade5th gradePlease list any allergies or other medical concerns that VBS staff should be aware of.Child's T-shirt Size *SMLDo you want to register another child? *YesNoSecond Child's Name FirstLastSecond Child's BirthdateSecond Child's GenderMaleFemaleSecond Child's Grade (current 2021-2022 school year)Pre-k (Because we will be outside this year, our 3 and 4 year olds need to be accompanied by a teen or adult "shepherd.")Kindergarten1st grade2nd grade3rd grade4th grade5th gradePlease list any allergies or other medical concerns that VBS staff should be aware of. Second Child's T-shirt SizeSMLDo you want to register a third child?YesNoThird Child's NameFirstLastThird Child's BirthdateThird Child's GenderMaleFemaleThird Child's Grade (current 2021-2022 school year)Pre-k (Because we will be outside this year, our 3 and 4 year olds need to be accompanied by a teen or adult "shepherd.")Kindergarten1st grade2nd grade3rd grade4th grade5th gradePlease list any allergies or other medical concerns that VBS staff should be aware of. Third Child's T-shirt SizeSMLParent Contact InformationName *FirstLastParent Email *Best phone number to reach you. *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeI'm affiliated with: First English LutheranSecond PresbyterianUniversity BaptistCathedral of the IncarnationOtherMy family intends to make a registration payment by:Paying Online (Link Provided Below)Mailing a check (Address Provided Below)Bringing a check to the first day of VBSParent Release Form *I agree to the terms of the Parent Release FormI, the parent/guardian of the above registered minor/minors, hereby authorize the director/s or adult leaders or caregivers of The Churches of Charles VBS to act on my behalf while I am absent, and consent to any x-ray examination, medical, dental or surgical diagnoses, medical treatment and hospital care advised and administered by emergency personnel or health care providers. A representative of The Churches of Charles will attempt to contact me in case of emergency. I hereby release The Churches of Charles, their staff, teachers, agents and advisors, from responsibility and liability for any injury or illness my child may sustain or from any claims, causes of action or demands that may arise in connection with my child’s/children’s participation in Vacation Bible School for any reason; including, but not limited to, claims of negligence of third parties in connection with, related to or as a result of any of these activities. This authorization shall remain in effect until revoked in writing and delivered to authorized agents of The Churches of Charles. I also give The Churches of Charles permission to use, reprint and produce any photographs or videos taken of my child/children during his/her/their participation in church activities. I understand that these images will remain anonymous and be used for ministry purposes only. Comment or MessageSubmit