VBS Registration 2025

Vacation Bible School 2025 Registration

First Presbyterian Church of Brandon June 9-13 8:45am-noon
Ages 3 year old -5th Grade | Snacks will be provided | Cost $25 per child
Child's Name / Nickname
Date of Birth
Age
Grade Completed in June 2025

Not in School yetKindergarten1st grade2nd grade3rd grade4th grade5th grade
Gender

MaleFemale
T-Shirt Size

Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult Large
Add Another Child

YesNo
2nd Child's Name / Nickname
Date of Birth
Age
Grade Completed in June 2024

Not in School yetKindergarten1st grade2nd grade3rd grade4th grade5th grade
Gender

MaleFemale
T-Shirt Size

Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult Large
Add Another Child

YesNo
3rd Child's Name / Nickname
Date of Birth
Age
Grade Completed in June 2025

Not in School yetKindergarten1st grade2nd grade3rd grade4th grade5th grade
Gender

MaleFemale
T-Shirt Size

Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult Large
Add Another Child

YesNo
4th Child's Name / Nickname
Date of Birth
Age
Grade Completed in June 2025

Not in School yetKindergarten1st grade2nd grade3rd grade4th grade5th grade
Gender

MaleFemale
T-Shirt Size

Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult Large
If you have additional children please list their information here.
PARENT / GUARDIAN INFORMATION:
Parent / Guardian 1 name:
Phone
Email
example@example.com
Parent / Guardian 2 name:
Phone:
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMERGENCY CONTACT (Must be different from parent)
Name
Phone
Relationship
Persons Authorized to Pick Up

(ID WILL BE REQUIRED IF OTHER THAN PARENT)
NAME
RELATIONSHIP
PHONE NUMBER
Add additional pick up person

YesNo
2nd Pick up Person's Name
RELATIONSHIP
PHONE NUMBER
Add additional pick up person

YesNo
3rd Pick up Person's Name
RELATIONSHIP
PHONE NUMBER
Add additional pick up person

YesNo
4th Pick up Person's name
RELATIONSHIP
PHONE NUMBER
Is anyone legally restricted from seeing this camper

yesno
Name of person restricted from seeing the camper
Medical Alert Information (ie: Allergies, Medical conditions)

(If none please write n/a)
Food Allergies
Other Allergies
Medical Conditions
Special Needs
Physician's Name
Physician's Telephone
AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT:

If my child(ren)should become ill or injured at First Presbyterian Church of Brandon, I understand that the VBS staff will: (1) Contact me immediately and (2) Contact the person(s) I have designated in the case that I cannot be reached. Should the staff be unable to reach me or the person(s) designated, they are authorized to contact my child's physician and/or arrange medical treatment. I will accept responsibility for payment of medical services rendered.
Signature

Clear
Relationship to Children
Date

MonthDayYear
Date
Photography

I give permission for my child(ren) listed above to be photographed at camp for internal and promotional purposesI do not give permission
You will be directed on the next page to make a payment. If you prefer to pay with a check please bring it to the church office.

Questions contact Karen Weber 813-545-2079 or Phoebe Irby 813-431-6607

First Presbyterian Church of Brandon
121 Carver Avenue, Brandon, FL 33510
813-689-4597
church@fpcbrandon.org
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Vacation Bible School 2025 Registration

PARENT / GUARDIAN INFORMATION:

Persons Authorized to Pick Up