2026 VBS Registration

Southern Pines United Methodist Church VBS

Registration
We are excited to welcome students to our summer Vacation Bible School program, Living Waters! VBS will run in the evenings beginning at 5:30 to 7:40 from Monday, July 13th thru Thursday, July 16th. Then on Sunday, July 19th at 9:00am participants are invited to share songs and celebrate the end of camp at our VBS Worship Service. Registration is free and dinner will be included each evening. Don't miss out on this amazing opportunity for fun and fellowship! Registration will be available until Sunday, June 14th and is open to PreK (4 years old) through rising Sixth Graders.

If you have any questions, please email rrosellini@sopinesumc.org
Parent / Guardian Information

All parents/guardians listed here will be allowed to pick up participants at the end of each day.
- Name
  
  First NameLast Name
- Email
  example@example.com
- Cell Phone
  Format: (000) 000-0000.
- Work Phone
  Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Relationship with the Participant(s)
- I am available to volunteer to help with VBS. (crafts, meals, etc.)
- Name
  
  First NameLast Name
- Email
  example@example.com
- Cell Phone
  Format: (000) 000-0000.
- Work Phone
  Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Relationship with the Participant(s)
- Participant's Information
  
  Personal & Health & Contact
- Name
  
  First NameLast Name
- Birth Date
  
  MonthDayYear
- Age (at time of camp)
- Grade (2026-27 School Year)
- T-shirt Size:
- List Any Allergies and Dietary Restrictions
- Medications that will come to VBS with child (inhaler, EpiPen, etc)
- Any medical conditions that staff should be aware of?
- Name
  
  First NameLast Name
- Birth Date
  
  MonthDayYear
- Age (at time of camp)
- Grade (entering this fall)
- T-shirt Size:
- List Any Allergies and Dietary Restrictions
- Medications that will come to VBS with child (inhaler, EpiPen, etc)
- Any medical conditions that staff should be aware of?
- Name
  
  First NameLast Name
- Birth Date
  
  MonthDayYear
- Age (at time of camp)
- Grade (entering this fall)
- T-shirt Size:
- List Any Allergies and Dietary Restrictions
- Medications that will come to VBS with child (inhaler, EpiPen, etc)
- Any medical conditions that staff should be aware of?
- Emergency Contact
  
  Please provide one or two emergency contacts. This person has permission to pick up your child at the end of each day if needed. This person should not be a previously listed parent or guardian.
- Name
  
  First NameLast Name
- Relationship with the Participant(s)
- Phone Number
  Format: (000) 000-0000.
- Email
  example@example.com
- Name
  
  First NameLast Name
- Relationship with the Participant(s)
- Phone Number
  Format: (000) 000-0000.
- Email
  example@example.com
- Medical Permission and Liability Release
- We (I) the parent(s) or legal guardian(s) of ________ hereby grant our (my) permission for him/her to participate fully in events and activities sponsored by or attended by the Southern Pines United Methodist Church during the time period of July 14, 2025 through July 20, 2025.
  
  Authorization and permission is hereby given to the Southern Pines United Methodist Church to furnish any necessary food for this participant during the week of 2025 VBS.
  
  I understand all safety precautions will be taken at all times by the Southern Pines United Methodist Church and its agents during all events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold the Southern Pines United Methodist Church, its leaders, employees, and/or volunteer staff liable for damages, losses, diseases, or injuries incurred by the participant who is the subject of this form. Furthermore, I (and on behalf of my youth - participant if under the age of 21 years) hereby assume all risk of personal injury, sickness, death, damage, and expense as a result of participation in recreation and work activities involved therein.
  
  I understand that in the event medical intervention is needed, every attempt will be made to contact immediately the persons listed on this form. In the event I cannot be reached, or the alternate contact person cannot be reached in an emergency I hereby give my permission to the physician or dentist selected by the activity leader to hospitalize, to secure medical treatment and/or to order an injection, anesthesia, or surgery for my child as deemed necessary.
  
  I understand that my insurance coverage for my child will be used as primary coverage in the event medical intervention is needed. Coverage by the Southern Pines United Methodist Church can be used as a backup policy only if the accident or injury takes place on the church property.
  
  Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action, or otherwise, I hereby assume all transportation costs.
- Permission to Use Likeness
- I do hereby give my permission for my dependent child’s likeness and/or photograph to be used for informational, promotional, and celebration purposes for the Children and Youth Ministries of Southern Pines UMC (in print, video, multimedia, and internet) for the period beginning July 13, 2026 through July 19, 2026. This includes the streaming of worship on Sunday, July 19th.
  
  The above stated church agrees to make every effort to protect the privacy and dignity of your children. If you or your dependent request that a picture be removed, it will be done so immediately. In the case of an internet picture, this will be done as soon as possible. In the case of a printed picture, this will be done the next time it goes to print.
- Should be Empty:

Southern Pines United Methodist Church VBS

Parent / Guardian Information

Participant's Information

Emergency Contact

Medical Permission and Liability Release

Permission to Use Likeness