Tropical Trek VBS Registration Form
Sunday, July 26 @ 10:30 am - Noon at Megaplex Upstairs Suite, 3601 S 2400 W, WVC
Friday, July 31 @5:30 pm - Dinner will be served. Camp Marino, 2432 W Victorian Drive,
Riverton Utah. This date includes an overnight camp over.
Saturday, August 1 @ 8am-VBS continues throughout the day concluding with a Back-to-
School Party and Waterslide adventure.
"Join us for an exciting adventure as we discover God's love together!"
Child Information
Child's Name:
Preferred Name (if different):
Date of Birth:
-
Month
-
Day
Year
Date
Age:
Grade (Fall):
Gender (optional):
Male
Female
Prefer not to say
Parent/Guardian Information
Parent/Guardian Name:
Relationship to Child:
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone:
Format: (000) 000-0000.
Secondary Phone:
Format: (000) 000-0000.
Email Address:
example@example.com
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Emergency Contact (If Parent/Guardian Cannot Be Reached)
Name:
Relationship:
Phone Number:
Format: (000) 000-0000.
Medical Information
Does your child have any allergies?
No
Yes (Please list.)
Does your child have any medical conditions we should know about?
No
Yes
Is your child currently taking any medications that may affect participation?
No
Yes
Special instructions or accommodations:
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Authorized Pick-Up
Please list adults (other than parents/guardians) who are authorized to pick up your child.
Please list adults (other than parents/guardians) who are authorized to pick up your child.
Rows
Name
Relationship
Phone Number
1
2
3
4
Church Information
Do you regularly attend a church?
Yes
No
If yes, Church Name:
Photo & Video Permission
During VBS, photos and videos may be taken for church publications, social media, and promotional materials.
Photo & Video Permission
Yes, I give permission for my child to be photographed/video recorded.
No, I do not give permission.
Transportation
How will your child arrive and depart each day?
Parent/Guardian Drop-Off & Pick-Up
Other (Please explain.)
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Additional Information
Anything else you'd like us to know about your child?
Parent/Guardian Consent
I give permission for my child to participate in Tropical Trek VBS including water activities. I understand that reasonable precautions will be taken for my child's safety. In the event of an emergency, I authorize church staff and volunteers to obtain appropriate medical care if I cannot be reached.
Parent/Guardian Signature:
Date:
-
Month
-
Day
Year
Date
Church Use Only
Registration Received:
Class/Group:
Leader:
Notes:
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