2024 VBS Participant Registration

Camper's Name

Parent/Family/Guardian Name

Address

This address will receive a confirmation email

Preferred Phone

Alternate Phone

Date of Birth

Age

Last school grade completed

Home Church (if any)

Friends of your child at the church

Special Needs/Allergies/Medical Information/Other:

Emergency Contacts

First Contact Name

First Contact Phone

Second Contact Name

Second Contact Phone

Name(s) of person(s) who may pick up this child from VBS

Photo Release

If I do not opt-out, Olmsted Community Church has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

Photo Release Opt-Out Opt-Out of Photo Release

Parent/Guardian who filled out this form:

Donation to help offset VBS Cost

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

July 22-26 || 9am - 12:15pm

Please fill out this form for each child you're registering for Camp Firelight VBS @ Olmsted Community Church.

2024 VBS Participant Registration

Description

Please Fix the Following