New Customer Registration Form

VBS Kid's Camp Registration

Please fill out one form for each child
Full Name of child

First NameLast Name
Grade that the child is going into:
Birthdate

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please list any allergies or conditions that we should be aware of.
Parent's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Contact

First NameLast Name
Phone Number (must be a different phone number than above)
Please enter a valid phone number.Format: (000) 000-0000.
Also, if there are siblings that are 14+ that would like to volunteer during the week of VBS (July 20-24), we would love to have them.

We will need help moving the groups from one station to another; timing the stations so we stay on schedule; assisting at the stations; or helping little ones with tasks.

Email office@hillsofpeace.com and let us know who would like to be involved.
Photo Release:

I hereby give Hills of Peace Lutheran Church permission to take photographs of my child, or photographs in which they might be involved with others, for the sole purpose of promoting the ministry of Hills of Peace Lutheran Church. I understand that these photos may be posted on Hills of Peace Lutheran Church website or social media.
I hereby release and discharge those taking photographs on behalf of Hills of Peace Lutheran Church from any and all claims arising out of use of the photos. (Please select one)
Signature
GUIDELINES

- Children will be given a healthy snack each day. You are welcome to send a snack with them if you prefer.

- Children can bring their own water bottle if they wish.

- Please ensure that children have sunscreen on before they arrive in the morning, as they will participate in some recreation activities outside.
Should be Empty:

VBS Kid's Camp Registration