Preschool VBS 2020
June 9-12, 2020 9:00 -11:00 AM
Trinity Evangelical UMC
108 Malabar Dr Upper Sandusky OH 43351
West End
Contact Jen Homburg  jen@mytrinity.us or Jenny Eyer-Kerr at jenny@mytrinity.us 
(419) 294-1535
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Child Information
Please complete the following information for each child registering to attend Preschool VBS 2019
Child Last Name *
Child First Name *
Best Contact Email to share information about VBS *
Street/Mailing Address *
City State Zip
Gender *
Birth Date *
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DD
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My child will be __ age at the time of VBS 2020 June 9-12 *
We ask that all participants are potty trained.  Is the registered child potty trained? *
Please list any allergies, medical conditions, and/or physical limitations for the child. *
My child can have cookie snack during VBS.
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Will your child bring medications, with him/her including Epi Pen or inhaler?   *
Request to be in same group with another child? Please indicate child's name or simply type none. We will do our best to accommodate this request *
Request to be in the same group with specific leader?  Please indicate leader's name or simply type none.  We will do our best to accommodate this request *
Parent/Guardian Information
Parent/Guardian Name #1 *
Parent/Guardian #1 Contact Number During Event *
Parent/Guardian #1 Address If Different
Parent/Guardian Name #2
Parent/Guardian #2 Contact Number During Event
Parent/Guardian #2 Address If Different
Emergency Contact Information
Please identify who we should contact in the event the parent is not reachable
Emergency Contact #1 Name *
Emergency Contact #1 Relationship *
Emergency Contact #1 Contact Number *
Emergency Contact #2 Name
Emergency Contact #2 Relationship
Emergency Contact #2 Contact Number
List people authorized to pick up child including Parents/Guardians and Emergency Contact People listed above.   *
Pick Up Procedure - I understand that all authorized pick up people will be asked to show ID at the time of pick up daily and have informed pick up people of this expectation for a smooth and safe transition.  Thanks for your support! *
Permissions
Permission - I give permission for my child to participate in the VBS program at Trinity Evangelical UMC. I here by voluntarily assume all risk of accident and injury to my child which may arise from his/her participation in this event, completely releasing Trinity Evangelical UMC and all personnel associated with the event form liability that may result from his/her participation. *
Text - I give Trinity Evangelical and Sonlight Children’s Ministry permission to add my phone number to their Text Signal program and agree to receive texts from them. *
Photos/Digital Images - I give Trinity Evangelical and Sonlight Children’s Ministry my permission for my child’s picture to be taken and used for church promotion such as during services, on church displays and publications like bulletin/ newsletter, and church website and Facebook page. *
Medical Treatment – In the event that I, the undersigned cannot be reached in an emergency, I hereby give my permission to the physician, dentist, or hospital selected by the staff to secure proper medical or dental treatment for my child named above. I agree to be liable and pay all costs and expenses incurred in connection with such medical and dental services rendered. *
PARENTS/GUARDIANS - If you acknowledge and agree that all the information above is correct and you have given your child permission to attend the 2020 Preschool VBS Sonlight Children’s Ministry please type your name below. Your typed named below will be a symbol of your signature for this agreement. *
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