Name and best phone # of another person to reach if we cannot reach you in the case of an emergency.
Your answer
Please list the names of people other than the guardians listed above who have permission to pick up your children from VBS.
Your answer
Participant Information
Please list the name of each child you are registering and his or her age by the time of our VBS (July 14).
Your answer
If applicable please list any physical ailments, allergies, dietary needs, recent injuries, emotional or behavioral disorders, heart condition and/or medications we should be aware of for each of the children listed above.
Your answer
Consent
I give my permission for my child to attend this camp. In the event of an emergency I give permission to the holder of this form to consent to any medical treatment of hospitalization deemed wise by a licensed physician or emergency team. I also agree to be liable for any all costs involved in such emergency treatment.
Lunch
List the names of the children registered above that will partake of the lunch provided by St. Lucas:
Your answer
List the names of the children registered above that will bring along their own lunch:
Your answer
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