VBS 2024 (July 22-25)

Preschool-5th Graders (the grade your child will be in Fall of 2024) Please enter parent name in "Your Name" and enter child's information in the "Household Members" section.

Your name *

Email address *

Parent Phone Number *

Address *

Household members

PLEASE SELECT "ADD CHILD" TO ENTER YOUR CHILD'S INFORMATION AND REGISTER THEM FOR VBS

Need Bus? *

We will be running a bus route in Windsor for those who are unable to find transportation. We are limited on seats (13), so the bus will be filled in order of registrations received.

Yes

Emergency Contact *

Name, Phone Number & Relationship to Child

I give SCC permission to use my child's picture on church affiliated websites *

Yes

SCC Medical Release

IN CASE OF EMERGENCY: If I am unable to be reached, I give permission to the Smyser Christian Church, by its representatives to hospitalize, secure treatment for, and to order anesthesia or surgery for my child named above. I further agree to be responsible for any and all bills incurred for such treatment.

I, herby, give full authority to the representatives of Smyser to use his/her discretion in determining if such medical treatment is necessary, and I release the Smyser Christian Church (i.e. representative, leadership, and congregation) from any and all responsibility for the results of that determination.

I further release Smyser Christian Church and its representatives from any responsibility other than supervision and care of my child.

SIGNATURE OF PARENT/LEGAL GUARDIAN: *

Medical note

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