Vacation Bible School 2024 Registration

Parent Name

This address will receive a confirmation email

Phone

Address

Participant Name

Participant Birthday

Grade Entering

K 1 2 3 4 5

Participant T Shirt Size

YS YM YL AS AM AL

Allergies and/or other medical conditions (Not required, but sometimes helpful to share with necessary volunteers such as kitchen staff, crew guide, station leader, VBS directors)

Emergency contact, phone number, and relation

Does your child have an IEP, 504, or BIP, If yes, how can we better serve your child

COVID-19 Waiver: Assumption of risk and waiver of liability relating to Coronavirus/COVID-19 -Coronavirus/COVID-19 has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. St. Aidan's Episcopal Church (SAEC) will follow required state and local health guidelines for gatherings, however, SAEC cannot guarantee that you or your child(ren) will not become infected with COVID-19. Attending events on the SAEC campus could increase your risk and your child(ren)'s risk of contracting COVID-19. By checking the box, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by illness, and all related and subsequent outcomes. I agree to hold harmless SAEC, and all of its organizational associates, its staff, agents, event participants and volunteers in the event that I or my child(ren) contract COVID-19 before, during or after the event. I agree and understand that this release includes the claims, of any kind based on the actions, omissions, or negligence of SAEC, its employees, agents, and representatives.

Yes

I give Saint Aidan's Episcopal Church permission to display in church publications,, and on church social media, my child's picture. I understand that my child's name will not be used unless otherwise authorized. If this is an issue, please call the church.

Yes

Payment $25.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Vacation Bible School 2024 Registration

Description

Please Fix the Following