St. Matthew's VBS 2026: Snowball Mountain Challenge Participant Registration Form

St. Matthew's VBS 2026: Snowball Mountain Challenge Participant Registration Form
We are so glad your child is going to join us this summer for Snowball Mountain Challenge! VBS is June 22-26, 2026 from 9:00-12:00 and the cost is $75 with the option to stay until 1:00 for an extra fee. There are 4-5 activity stations each day plus the opening and closing assembly (with LOTS of music) and a snack. If you have any questions, please contact Kelli Hughes at vbs@stmattsaustin.org. We look forward to having your child!
Participant's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender*

FemaleMaleNonbinary
Date of Birth*

MonthDayYear
Date
Age as of June 1, 2026*
Grade for Fall 2026*
T-shirt Size*
Parent/Guardian 1 Name*

First NameLast Name
Parent/Guardian 1 Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 1 Email*
example@example.com
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 2 Email
example@example.com
Emergency Contact Name (other than parent/guardian listed above)*

First NameLast Name
Emergency Contact Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Does this child attend the St. Matt's Day School?*

YesNo
Do you have a home church? If yes, please list.*
Would you like more information about St. Matthew's*

YesNo
Permission to use Photos-VBS only: I hereby grant St. Matthew's Episcopal Church the unrestricted right to use and publish photographs or other images of the above listed child(ren), or in which the above listed child(ren) may be included, in any print, electronic, digital or other media; and to alter the same without restriction. I understand that the name of my child will not be included with any photograph or image used in any medium. I irrevocably assign such photographs' and images' rights and uses to St. Matthew's Episcopal Church into perpetuity. I hereby release St. Matthew's Episcopal Church and its legal representatives and assigns from all claims and liabilities relating to said photographs and images.*
Type your name to indicate your permission
Do you have accident/medical insurance that would cover your child in the event of an accident or medical emergency?*

YesNo
In the event of a medical or dental emergency where medical treatment is required, I give my permission for the church staff or representative to obtain the services of a licensed physician. In the event treatment is called for, which the medical provider refuses to administer without consent, I hereby authorize an adult representative to give such consent for me if I cannot be contacted immediately. I agree to hold such person free and blameless of any liability for damages arising from giving such consent provided. It is expected that in case of accident or emergency that the parent or legal guardian will be notified as soon as possible.
Type your name to indicate permission
In the event of a medical or dental emergency where medical treatment is required, I give my permission for the church staff or representative to obtain the services of a licensed physician. In the event treatment is called for, which the medical provider refuses to administer without consent, I hereby authorize an adult representative to give such consent for me if I cannot be contacted immediately. I agree to hold such person free and blameless of any liability for damages arising from giving such consent provided. It is expected that in case of accident or emergency that the parent or legal guardian will be notified as soon as possible.*
Type your name to indicate permission
Does your child have any allergies? If so, please list.
Are there any special medical or emotional conditions or issues we need to be aware of? If so, please list.
Does your child take any medicine that will affect him/her during the day? If so, please list.
Is there any other information that you want to provide that will enable us to better serve your child while they are with us at VBS?
Friend Request (maximum 2)
Lunch Bunch - I would like my child to stay until 1:00 everyday for an extra $25*

Yes, please!No, thank you.
Please indicate if one of the parents, grandparents or other related, responsible adult is a full time volunteer (3+ days) during the week of VBS (June 22-26). Please choose one:*

Yes, at least one parent will be volunteering full timeYes, at least one grandparent or other related adult will be volunteering full timeYes, our nanny will be volunteering full timeNo, no adult from our family will be volunteering full time
Optional Donation*

I cannot make an additional donation at this timeI would like to make an additional $10 donationI would like to make an additional $25 donationI would like to make an additional $50 donation
Total Payment

Registration Payment + Donation*

USDDescription

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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