2023 Registration for Vacation Bible School
Parent/Guardian Name *
Street Address
City - State - Zip Code
Phone # *

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###		-
####
Email Address
Willing to help at VBS?
 YES, I'm willing to volunteer. 
Church Affiliation

Emergency Contact Information

Emergency Contact *
Phone # *

###		-
###		-
####

Youth Attending VBS

This section is for listing the youth participating in this year's VBS as student.
NAME #1 *
Date of Birth *

MM		/
DD		/
YYYY
Child's Current Age *
Grade entering fall
of 2023 *
Food Allergies or Medical Concerns
NAME #2
Date of Birth

MM		/
DD		/
YYYY
Child's Current Age
Grade entering fall
of 2023
Food Allergies or Medical Concerns
NAME #3
Date of Birth

MM		/
DD		/
YYYY
Child's Current Age
Grade entering fall
of 2023
Food Allergies or Medical Concerns
NAME #4
Date of Birth

MM		/
DD		/
YYYY
Child's Current Age
Grade entering fall
of 2023
Food Allergies or Medical Concerns

Interested in being a Crew Leader

For youth entering 7th grade and older who would like to help at VBS
NAME #1
Grade in School
Volunteer Status
(please indicate whether new or returning)
NAME #2
Grade in School
Volunteer Status
(please indicate whether new or returning)

Authorizations

for transport of 5th & 6th graders to Retreat Center and use of pictures.
Transportation Authorization for 5th & 6th Graders
 Yes-I give permission for the VBS volunteer to transport my child to Saint John Retreat Center 
 No-I do not want my child transported to Saint John Retreat Center 
Authorization to use photos
 Yes, I give permission for the VBS staff to photograph/record my child and to possibly use it in our daily VBS slide show, Facebook Page and/or on the Saint John TV channel 
 No, please do not use photos taken of my child/children. 
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