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Vacation Bible School 2018 Registration

***NEW*** Online registration. To register your child, complete the Registration Form below, and hit "SUBMIT."
If you wish to pay online, you may do so using the "ADD TO CART" button at the bottom and following the instructions. 

Calvary Lutheran Church’s 2018 Shipwrecked Vacation Bible School is filled with incredible Bible-learning experiences for kids to see, hear, touch, and even taste! Science-Fun, team-building games, cool Bible songs, and tasty treats are just a few of the standout activities that help faith flow into real life. + Since everything is hands-on, kids might get a little messy. Be sure to send them in play clothes and safe shoes. +

WHEN: July 23rd to July 27th from 9:00am to 12:00pm. Space is limited! 
WHO: This exciting VBS is for children who will be 4 years old by September 1st, 2018 through current 4th graders. All kids who are members of Calvary and in 5th grade and up are welcome to participate in VBS as a Youth Volunteer. No registration fee is required for Youth Volunteers. Please contact Amy Taylor to request a Youth Volunteer Registration Form.

PAYMENT: 
Early Bird Registration Rate: $40 per child begins March 1.
Standard Registration Rate: $50 per child May 16 - June 15. + No registrations will be accepted after June 15 +

Scholarships available.  

The registration fee includes the Sing & Play Rock Music CD. We now accept credit card or PayPal payments; just follow the link at the bottom of this form. You can still pay using cash or check.

If you have questions or need additional information, please contact Amy Taylor.


Registration Form

Child 1 Name *
Child 1 Name
Child 1 DOB *
Child 1 DOB
If applicable
PLEASE NOTE THAT EPI-PENS SENT IN MUST HAVE A PRESCRIPTION WITH CHILD'S FULL NAME, DATE OF BIRTH, AND PHYSICIAN'S NAME.
Child 2 Name
Child 2 Name
If applicable.
Child 2 DOB
Child 2 DOB
If applicable
PLEASE NOTE THAT EPI-PENS SENT IN MUST HAVE A PRESCRIPTION WITH CHILD'S FULL NAME, DATE OF BIRTH, AND PHYSICIAN'S NAME.
Child 3 Name
Child 3 Name
If applicable.
Child 3 DOB
Child 3 DOB
If applicable
PLEASE NOTE THAT EPI-PENS SENT IN MUST HAVE A PRESCRIPTION WITH CHILD'S FULL NAME, DATE OF BIRTH, AND PHYSICIAN'S NAME.
Child 4 Name
Child 4 Name
If applicable.
Child 4 DOB
Child 4 DOB
If applicable
PLEASE NOTE THAT EPI-PENS SENT IN MUST HAVE A PRESCRIPTION WITH CHILD'S FULL NAME, DATE OF BIRTH, AND PHYSICIAN'S NAME.
Parent/Care Provider Name *
Parent/Care Provider Name
Preferred Phone *
Preferred Phone
Address *
Address
I would like to volunteer with VBS
2nd Parent/Care Provider Name
2nd Parent/Care Provider Name
Not required
Preferred Phone
Preferred Phone
Address, if different
Address, if different
I would like to volunteer with VBS
Emergency Contact *
Emergency Contact
At least one Emergency Contact is required
Emergency Contact Phone *
Emergency Contact Phone
Emergency Contact 2
Emergency Contact 2
Not Required
Emergency Contact 2 Phone
Emergency Contact 2 Phone
Physician Name *
Physician Name
Physician Phone *
Physician Phone
Insurance Subscriber Name *
Insurance Subscriber Name
Participation Permission and Liability Release Agreement *
I/We give my permission for the participant(s) named above to participate in VBS at Calvary Lutheran Church in West Chester, Pennsylvania for the week of July 23 -27, 2018. I release Calvary Lutheran Church from any and all liability to me or my child as a result of his/her participation. Also, I understand that Calvary Lutheran Church does not assume any responsibility for loss of, or damage to, personal property of the participant.
Medical Release Agreement *
In the event of an emergency, in which you are unable to reach me (parent/guardian), in case of injuries, accidents or illness, I give my permission for treatment deemed necessary in consultation between attending emergency physician and the VBS Director for Calvary Lutheran Church. I also release Calvary Lutheran Church and its program staff of liability in the case of accidents or injuries to my child while attending this church event.
Image Release Agreement *
I/We grant Calvary Lutheran Church permission to use my child(ren)'s likeness, without names, as recorded during VBS activities in photographs, video recordings or electronic images, in any and all of its publications, including website and social media entries, without payment or any other consideration.
Sponsorship
Help make VBS possible for another child. Simply add the number of sponsorships to your registration number and indicate "Sponsorship" using the payment method you choose.

***NOTE***  To register your child, complete the Registration Form above, and hit "SUBMIT."
If you wish to pay online, you may do so using the "ADD TO CART" button below and following the instructions. 


Online Payment

Vacation Bible School
40.00

We now accept online credit card or PayPal payment for registrations.

  • Indicate the number of children to be registered (Quantity)
  • Click "Add to Cart" button
  • Confirm the name(s) of registrants

Check or Cash Payments:
Make checks payable to "Calvary Lutheran Church." 
NOTE: Your child will not be registered until you complete and submit the registration form and payment is received.

Quantity:
Add to Cart