Vacation Bible School

Covenant Presbyterian Church

15002 Blondo St. | Omaha, NE 68116 | 402-498-9000

Monday, June 1 - Friday, June 5 | 9:00 - 12:00 PM

Ages 4-5th grade

(Please complete and submit a separate registration form for each child.)

Child Registration Form Volunteer Registration Form

VBS Registration

Child's Name:

Date of Birth

Last Grade Completed/Age

Name of Parent(s):

Address:

City:

State:

Zip:

Cellphone Number:

Email:

Emergency Contact:

Emergency Contact Phone:

Relationship to Child:

Person(s) Authorized to Pick Up Your Child:

Allergies (Food, latex, etc.):

Medical Conditions:

Home Church

Additional Info: (special needs, friend group request, etc.)

Check One: VBS may be photographed and later posted on Facebook or on the website. Please check one of the boxes to indicate if you give permission for your child's image to be included.

I give permission for my child's image to be included in online publicity for VBS.

I do not want my child's image included in online publicity for VBS.

I would be interested in future events at Covenant.

Please add me to the Special Events mailing list.

I give permission for my child to participate in Vacation Bible School (VBS) activities at Covenant Presbyterian Church. I understand that these activities may include indoor and outdoor play that involve certain inherent risks of injury. On behalf of myself and my child, I acknowledge and assume these inherent risks. I agree to release and hold harmless Covenant Presbyterian Church, its employees, and volunteers from claims arising out of my child’s participation, except to the extent caused by gross negligence or willful misconduct.

I agree

In the event of illness or injury, I authorize church staff or volunteers to obtain necessary medical treatment for my child, including emergency care. I understand that reasonable efforts will be made to contact me, and I accept responsibility for any medical expenses incurred. I certify that my child is physically able to participate in VBS activities and that I have disclosed any relevant medical conditions, allergies, or special needs.

I agree