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Vacation Bible School 2019 Registration

To register your child(ren), complete the Registration Form below, and hit "SUBMIT."
After you submit your form, you will be given an option to pay online using PayPal or a credit card. You may still pay using a check or cash, but your registration will not be complete until both the form and payment are received.

Calvary Lutheran Church’s 2019 ROAR! 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 22nd to July 26th 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, 2019 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 Volunteer.

PAYMENT: 
EARLY BIRD Registration Rate: $40 per child (until midnight April 30th, 2019)
After April 30th, registration is $50 per child.
+ Registration Closes June 15 +

Scholarships available.  

The registration fee includes the Music CD.

If you have questions or need additional information, please contact Tina Richardson.


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 1 VBS t-shirt options: *
(T-Shirts are $5 in addition to the registration fee for each child.)
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 2 VBS t-shirt options:
(T-Shirts are $5 in addition to the registration fee for each child.)
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 3 VBS t-shirt options:
(T-Shirts are $5 in addition to the registration fee for each child.)
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.
Child 4 VBS t-shirt options:
(T-Shirts are $5 in addition to the registration fee for each child.)
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 22 -26, 2019. 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.

After you submit your form, you will be given an option to pay online using PayPal or a credit card. You may still pay using a check or cash, but your registration will not be complete until both the form and payment are received in the church office.