2024 VBS Camp - World Tour Registration Form

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2024 VBS Camp - World Tour Registration Form

At the World Tour VBS Camp, kids will be challenged as they discover God's truth never changes and Jesus loves us. Kids will travel the globe learning cultures and languages through music, crafts, recreation, and Bible study to share God's Love and encourage kids everywhere to go, connect, and share!

Theme: World Tour (1 John 4:17)
Date: Monday, June 24 - Friday, June 28
Time: 9:00 am - 12:30 pm
(Drop-off from 8:45 am to 9:00 am & Pickup begins at 12 pm until 12:30 pm)
Location: VMBC Campus - 12221 Veirs Mill Road, Silver Spring MD, 20906
For: Children completed Grades K to 5 (space is limited)
Cost: FREE!
Special: Family Fun Night on Friday at 6:00 pm

*** Please submit 1 Registration Form per child ***

Hosted by:
Viers Mill Baptist Church (VMBC)
Fellowship Baptist Church (FBC)
Montgomery Chinese Baptist Church (MCBC)
Iglesia Bautista Hispana Viers Mill (IBHVM)
Maryland Chinese Baptist Church (MDCBC)

Contact Information

All correspondence for this registration will be sent to this person.

Parent/Guardian Name *

Address *

Phone *

Email *

Camper Information

Information about the attendee.

Date of Birth *

YYYY

Gender *

Male

Female

Completed Grade Level *

List the names of ALL adults who may pick up your child. (Include your name, as well as the names of all other adult relatives, caregivers, or other children's parents whom you authorize to pick up your child at the end of a camp day.)
*

Emergency Contact

Please fill in the emergency contact information for the attendee.

Name *

Relationship with the attendee *

Phone *

Medical Note

Please provide brief allergies, health concerns, and medical history of the attendee.

Please list ALL allergies your child has. (Enter "n/a" if not applicable). Note: Please provide a snack for your child each day if your child has food allergies. *

Please list any medications your child is on, including asthma inhalers and epipens. (Enter "n/a" if not applicable).
*

Please list any special medical, health, or educational needs and/or concerns for your child. (Enter "n/a" if not applicable).
*

Who is your child's doctor?
*

What is your child's doctor's phone number (xxx-xxx-xxxx)?
*

Please review and electronically sign this Medical/Liability/Photo Release Form by selecting "I have read and agree to the Medical/Liability/Photo Release Form".

Medical/Liability/Photo Release Form
I am the parent or guardian of the attendee noted above, who is a minor, and hereby acknowledge that said minor is/are presently under my care, custody, and control. I hereby give my child, said minor, my express permission to participate in VBS Camp at Viers Mill Baptist Church. In the event of an emergency necessitating medical and/or surgical attention, I hereby consent and give my permission to Viers Mill Baptist Church, or its representatives, or the church's chaperones, or any attending physician to make such decisions and to perform such medical treatments and/or surgery upon said minor which may, in their sole discretion, be necessary and proper under the circumstances. I, the undersigned parent or guardian of the attendee noted above, who is a minor, fully understand the nature of this activity and that my child will participate at his/her own risk. I do hereby release, acquit, discharge, and covenant to hold harmless Viers Mill Baptist Church, its representatives, and the church's chaperones from any and all actions, or liabilities arising out of activities related to VBS Camp, including, but not limited to the treatment of any sickness or accident incurred by my child during the dates indicated. I/We consent to the use of any video images, photographs, audio recordings, or any other visual or audio reproduction that may be taken of my child during the activities to be used, distributed, or shown as Viers Mill Baptist Church sees fit. I understand that my child(ren) is/are expected to obey camp rules and be respectful to the staff and other campers. I understand that if my child(ren) causes a consistent disruption to the camp or causes a safety hazard to themselves or others by their actions, they will be removed from camp. I acknowledge that each day my child(ren) is/are not picked up by 12:30 pm, I will be charged a $20 late pickup fee.
*

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