St. Andrew's Episcopal Church - VBS Adult & Teen Volunteer Registration

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Our VBS Theme: Passport to Peace

Monday, July 11 - Thursday, July 14
9:00 a.m. - 12:00 p.m.

Questions? Contact Harper Bathel at hbathel@standrewsnorfolk.org .

Directions: This form will allow you to share your information and register between 1 to 4 children. Please fill out the entire form and press submit after you finish. Thank you, we are thrilled your family is joining us! Stay tuned for more information to be shared by e-mail.

Email *

Your Name *

Parent or Guardian Name (if applicable)

Address

City

Zip Code

Cell Phone *

Additional Phone Number

Name of Emergency Contact in case parent cannot be reached *

Emergency Contact Phone Number *

Medical Insurance Company Name *

Medical Insurance policy number *

As the parent or legal guardian, I understand that every effort will be made to contact me before authorization of emergency treatment is given. In the event that I cannot be reached, or if immediate attention is required, I hereby authorize the St. Andrew’s adult leaders to appoint a licensed medical professional to provide treatment on my dependent child’s behalf and I agree to assume responsibility for all medical expenses. *

Yes

Required

I grant permission for my child and/or myself to appear in photos or videos recorded by St. Andrew's Episcopal Church during Vacation Bible School and for these photos to be used on their website and the church's social media pages. *

Yes

Required

How did you learn about our VBS?

Home Church?

Volunteer's Name

Adult or Teen (if a teen, please share age)

Teen's Last Grade Completed (Summer 2022)

Any allergies or medical concerns?

Voluteer's Name

Adult or Teen (if a teen, please share age and birthday)

Teen's Last Grade Completed (Summer 2022)

Any allergies or medical concerns?

Volunteer's Name

Adult or Teen (if a teen, please share age and birthday)

Teen's Last Grade Completed (Summer 2022)

Any allergies or medical concerns?

Enter your name here to sign this form (required)* *

Today's Date (required) * *

YYYY

Please name all persons authorized to pick-up your child from VBS each day (Students will not be allowed to leave with anyone not on this list.): * *

Anything else you would like us to know?

Submit

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