2026 VBS REGISTRATION

2026 VBS REGISTRATION

The Salvation Army Wiarton Community Church
Child's Full Name (additional children can be added at the end of this form)

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Complete Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Mailing Address - only if different than above

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Who is authorized to pick up your child? (Full first and last name - ID may be required)

First NameLast Name
Emergency Contact Name

First NameLast Name
Relationship to Child
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Any food or other allergies, asthma, diabetes, special needs, behavioural concerns or other information we should be aware of? Do they have an EpiPen or inhaler?
How did you hear about this event?
Do you give permission for your child(ren)’s photo to be taken and potentially shared on our website or Facebook page?
I hereby give authorization to The Governing Council of The Salvation Army in Canada, The Salvation Army Canada and Bermuda Territory, and all associated and related charities (collectively referred to throughout the remainder of this document as "The Salvation Army") to use the story, photos, audio or video, of my minor child(ren) listed below, for any and all marketing, public relations and promotional purposes, which The Salvation Army may, in their sole and absolute discretion, deem appropriate.
Medical Treatment Authorization: In case of emergency, I authorize VBS staff/volunteers to seek necessary medical treatment for my child(ren).
Release & Waiver: I release the church and VBS staff/volunteers from liability for injuries or accidents that may occur during VBS activities.
Parent/Guardian Signature
Add Another Child
Child #2 Full Name

First NameLast Name
Child #2 Date of Birth

MonthDayYear
Date
Child #2 - Any food or other allergies, asthma, diabetes, special needs, behavioural concerns or other information we should be aware of? Do they have an EpiPen or inhaler?
Child #3 Full Name

First NameLast Name
Child #3 Date of Birth

MonthDayYear
Date
Child #3 - Any food or other allergies, asthma, diabetes, special needs, behavioural concerns or other information we should be aware of? Do they have an EpiPen or inhaler?
Child #4 Full Name

First NameLast Name
Child #4 Date of Birth

MonthDayYear
Date
Child #4 - Any food or other allergies, asthma, diabetes, special needs, behavioural concerns or other information we should be aware of? Do they have an EpiPen or inhaler?
Should be Empty: