Clone of PC 2025 VBS Registration Form

Vacation Bible School Registration
- Parent/Guardian Information
- Guardian's Name
  
  First NameLast Name
- Gender
- Relationship
- E-mail
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- May we text this number?
- Home Church Affiliation
- Emergency Information
- Emergency Contact's Name
  
  First NameLast Name
- Relationship
- Emergency Contact's Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- May we text this number?
- NEW THIS YEAR!! - CHILD-CHECK IN & PICK-UP POLICY
  
  🚨New System 🚨
  
  This year, we’re using the OneTap Check-In system to create a faster, smoother, and more secure check-in and pick-up experience for your family! We’re excited to roll out this new QR code system to make arrival and dismissal quicker, more accurate, and easier for both families and volunteers—helping every child get where they need to be safely and without the wait.
  
  Check-In ➡️
  
  Each family will receive a QR code via email to use for daily check-in—just have it ready (on your phone or printed) during registration and each day at arrival.
  
  Check-Out ⬅️
  
  Children must be picked up by an authorized adult. At the end of each day, simply scan your QR code to check your child out—it’s quick, easy, and helps us keep everything running smoothly. For everyone’s safety, children will not be released into the parking lot to find their arranged transportation, so please plan to pick them up inside the sanctuary where they’ll be waiting for you.
  
  Preschool children must be checked out by their parents from the church nursery classroom using their QR code.
  
  Alternate Pick-Up 🔀
  
  Please list anyone who has permission to pick up your child and make sure they know to bring the QR code for check-out. *If more than two (2) alternate names are needed, just let our registration team know—we’re happy to help!
  
  Thank you for partnering with us to make this a safe, smooth, and super fun VBS week! 🎉
- Alternate Pickup Information
- Alternate Pickup 1 Name
  
  First NameLast Name
- Alt. Phone Number
  Format: (000) 000-0000.
- Alternate Pickup 2 Name
  
  First NameLast Name
- Alt. Phone Number
  Format: (000) 000-0000.

Participant Information

Child(ren) attending VBS
Group Assignment Preference

Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise that all requests will be possible.

- Photo/Video Consent and Acknowledgement
  
  In accordance with our safe place policy, we need your permission to include your child in any photographs and/or video that may be taken during the week of VBS. These pictures and/or videos would only be used in conjunction with Vacation Bible School and VBS Sunday Celebration and/or promotion for future Vacation Bible School events.
  
  Price Chapel has my permission to include my child in any or all parts of video and/or pictures during the week of June 8th-12th, 2026.
  
  I hereby grant the right and unrestricted permission to use the above registered name(s), likeness, image, voice, and/or appearance as such may be embodied in any photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of Price Chapel or its partners. I agree that Price Chapel has complete ownership of such material and can use said material for any purpose consistent with Price Chapel’s mission. These uses include, but are not limited to videos, publications, advertisements, news releases, web sites, and any promotional or educational materials in any medium. I acknowledge that I will not receive any compensation for the use of such images, video, likeness, etc.
  
  I hereby release and discharge Price Chapel, and its agents, representatives and assignees from any and all claims and demands arising out of or in connection with the use of the registered name(s), likeness, image, voice and/or appearance, including any and all claims for invasion of privacy, right of publicity, misappropriation or misuse of image, and/or defamation.
- Initials
- Medical Release and Authorization
  
  As Parent and/or Guardian of the registered particpant(s), I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
  
  Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the registered participants(s). In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.
  
  Permission is also granted to Price Chapel, and its agents, representatives and assignees to provide the needed emergency treatment prior to the child’s admission to the medical facility.
  
  Release authorized on the dates and/or duration of the registered event.
  
  This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
- Initials
- Confirmation
  
  BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
- Signature
- Date
  
  MonthDayYear
  Date

Help make Price Chapel VBS great!

Price Chapel suggests a $10 donation per registered child. *Cash and Card donations may be accepted at registration the week of VBS.

Suggested Donation $10 (per child registered)

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Credit Card

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Vacation Bible School Registration

Participant Information

Group Assignment Preference

Help make Price Chapel VBS great!

Suggested Donation $10 (per child registered)

Credit Card