2025 Vacation Bible School Registration Form

VBS REGISTRATION

The non-refundable registration fee will be $30.00 for the first child and $5.00 for each additional child. This registration is provisional until the fee is received and can be by made by check (payable to Trinity Presbyterian Church) or with cash in person. Our address is 640 Berwyn Ave. Berwyn, PA 19312. A receipt/reservation confirmation will be sent to you by email.
Child Information

Fill out for each child you would like to register
Child 1 Full Name*
Gender*

MaleFemaleOther
Grade in September 2025
Birth Date*

MonthDayYear
Child 2 Full Name
Gender

MaleFemaleOther
Grade in September 2025
Birth Date

MonthDayYear
Child 3 Full Name
Gender

MaleFemaleOther
Grade in September 2025
Birth Date

MonthDayYear
Child 4 Full Name
Gender

MaleFemaleOther
Grade in September 2025
Birth Date

MonthDayYear
Are you able to volunteer to help with Vacation Bible School for one day during the week?

YesNo
Family Contact Information
Parent Name*

First NameLast Name
Address*
City/State/Zip*
Email*
example@example.com
Phone Number*

Area CodePhone Number
Emergency Contact Name(if parent or guardian is not avaliable)*
Emergency Number*

Area CodePhone Number
Emergency Number #2

Area CodePhone Number
Approved Pickup

please list all individuals who are approved to drop off/pick up from camp
Approved Pick Up #1*
Relation*
Cell Phone*

Area CodePhone Number
Approved Pick Up #2
Relation 2
Cell Phone 2

Area CodePhone Number
Approved Pickup #3

First NameLast Name
Relation 3
Cell Phone 3

Area CodePhone Number
Health Information
All fields are required below. If nothing applies, please put "NONE" in the box.
Any activity the child should be restricted from?*
Is there anything we should take into consideration in planning our day (i.e. calming spaces for neurodiverse children, etc.)*
List any past medical treatment that would be helpful for us to know.*
List any allergies (ex: bees,peanuts, dairy)*
Any dietary needs that we should know about?*
List all medications, both prescribed and over the counter. All medications will be turned into the Church Nurse except rescue inhalers. Please bring all medication in original containers.*
Photo Consent
Do you give Trinity Presbyterian Church permission to take and post photos of your child for promotional material (web, media, or print)?*

Yes, I give consentNo, I do not give consent
By entering your name and initials, you agree to the following:

* I am the parent or legal guardian of the above named child, and am over the age of 18.

* In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named child by authorized personnel.

* I understand that the above named child will only be released to the names listed above.

* I certify that the above named child has my permission to attend VBS and participate in all activites.
Printed Name*

First NameLast Name
Date*

MonthDayYear
Date
Electronic signature, please initial*
Should be Empty:

VBS REGISTRATION

Child Information

Family Contact Information

Approved Pickup

Health Information

Photo Consent