St Paul UCC - Waterloo VBS Registration (2024)
St. Paul VBS will be offered on Tuesday, May 28th through Friday, May 31st from 9:00 am until noon. Pre-K children (aged 4 or 5, who will be enrolled in Kindergarten in the fall) through those who will have completed 5th grade are invited to participate.
 
The cost of the program is $15 per child which will include all materials, snacks, and a t-shirt.

Please complete this form for each child who will be participating in VBS. 
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Student Name *
Student Grade (for fall 2024) *
Child's Birthdate
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DD
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YYYY
Child's T-Shirt Size *
The first 50 families to register for VBS have the opportunity to receive a FREE VBS music cd.

Would your family like to receive a VBS music cd?
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Any Allergies? Any Medical Conditions?
Child's Home Address *
Any other information we should be aware of?
Parent Name(s) *
Parent Email(s) *
Parent Phone Number(s) *
Parent Address(es) (if different from child)
Emergency Contact Name(s) & Phone Number(s) *
Individuals Who Are Permitted to Pick Up Your Child at Program's End *
Permissions
By entering a digital signature below I give permission for participation in the 2024 Vacation Bible School activities at St. Paul UCC, Waterloo, IL.  By registering my child and signing this form, I agree that the staff of VBS at St. Paul UCC, Waterloo has my permission to administer any first-aid deemed appropriate, until proper medical attention can be reached.  I understand that the VBS staff members will do everything in their power to ensure the safety of each child, but that neither they nor St. Paul UCC, Waterloo can be held responsible for accidents that might occur due to factors beyond their control.  

Further, St. Paul United Church of Christ cannot prevent your child from becoming exposed to, contracting, or spreading any illness, including COVID-19, while in attendance at VBS. It is not possible to completely prevent against the presence of the disease. Therefore, if you choose to send your child to VBS you may be exposing him/her as well as yourself to and/or increasing your risk of contracting or spreading an illness.

By entering a digital signature below, you acknowledge that you have read and understood the above warning concerning illnesses including COVID-19 and are choosing to accept the risk of contracting an illness for your child and yourself in attending VBS at St. Paul UCC in Waterloo.

By entering a digital signature below, I hereby forever release and waive my right to bring suit against St. Paul UCC Waterloo and its owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with exposure, infection, and/or spread of any illness, including COVID-19. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

Permission/Waiver (Please Sign/Enter Parent Name) *
Do you give permission for your child’s photo and name to be printed in the newspaper or church website and publications? *
Payment
The cost of VBS is $15 per child which covers all materials and a VBS t-shirt. Payment can be dropped off (or mailed to) at church [200 N Main St., Waterloo, IL 62298] or payment can be paid online by visiting https://onrealm.org/STPUCC/give/now . Simply select VBS as the fund designation.
We can't wait to see your child in May!!!
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