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Participant Registration

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Registro en Español

Memorial Baptist Church

Location

224 Taylor Street

Staunton, VA 24401

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Contact Kylene Smithkin:

540-294-5151

smithkinfamily@gmail.com

First, Tell Us About Yourself:

Parent Information

This first section is PARENT Information, NOT the child's info. So please add the parent/grandparent/guardian's first and last name.

Child's section will be next! You can add as many children as you need to on one form. No need for parents to fill out several forms! After the orange section at the bottom there is an "add another participant button" just click that to add another child!

First Name

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Last Name

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MAILING address - We send the children fun letters!! ***If you have a different address from the child's there is an area on their registration form to add a different address. If you live in an apartment please add the apartment number

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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The emergency info below is the FIRST person we would call if your child is sick or injured. This could be the person who fills out the form, or someone else. This person would be contacted before the contact phone number listed above!

Thanks

Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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What church do you currently attend? *If you do not attend a church please put that you don't currently have a church (No Judgement here)

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Sunday Family Day June 7th, 10:00 A.M: We are having a family fun day, The children will sing during our church service and we will share testimonies from the week. There will be lunch afterwards along with activities for the children. Please let us know if you are hoping to attend

Multiple selections are allowed.

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How did you hear about our VBS? Maybe our church banner, or you have attended in the past, maybe another mom invited you! We would love to know :) If someone else invited you please add their name, so we can thank them!!

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For pickup this year; you will come inside to pick your children and you will find your child(ren)'s leader from inside. Make sure YOU as the adult are going to each crew if you have multiple children. Once you have your children please exit the sanctuary (feel free to stand outside the sanctuary to talk or outside of the building but we ask that you leave the sanctuary)!!

You will need to do this EACH day, on day 1 when you DROP your child(ren) off you will receive a list that has each of your child(ren)'s name and where they will be sitting in the sanctuary, this will help you find them at pickup time. Feel free to take a picture of this to send to whoever is picking them up.

Comments

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

Put the child's name they want on their name tag!!

First Name

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Last Name

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ELEMENTARY ONLY: Child's Address IF different than ABOVE: Include city, and zip code (We will be sending the children special letters from their crew guides after VBS!)

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Please note you will put the grade your child JUST FINISHED.

2026 GRADE CHANGE: The child must have FINISHED Kindergarten to attend VBS. We will not be take preschoolers this year. Thank you for your understanding in this change.

Grade Leaving

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Gender

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Date Of Birth

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I, Kylene (director), will send out a snack list for ELEMENTARY children before VBS, via email. IF your child has an allergy PLEASE look over the snack list and plan accordingly.

If your child will be bringing their own snack, due to allergies, please make sure they have their First and Last names on their bag and hand to then registration ladies. THEY do not carry their snacks around with them!

Thank you

FOOD Allergies

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Please understand we are unable to provide 1 on 1 "care" for your child. If your child needs 1 on 1, then you must stay with your child. Please be VERY specific with any "health or behavior" concerns. This helps us to make sure they have the best experience possible!!

Do any of these pertain to your child? If so, please mark all that apply and then expand further in the next box!

Multiple selections are allowed.

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Please clarify specifics from box above: Please provide additional details that will enable our volunteers to help with your child. We want your child to have a great time at VBS!

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Availability- if there is a day or more they CANNOT attend please mark it below

Multiple selections are allowed.

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If you realize after you register your child that they are unable to attend please contact the director as soon as you know. This may allow space for another child.

Kylene Smithkin - smithkinfamily@gmail.com

This is a signature section: Please type your name as your signature to the ones that apply to you. Please do NOT add a check mark, or say ok. Type your NAME!!!

Signature below: LIABILITY RELEASEI (we), the undersigned parent(s)/guardian(s) of child or children on form, a minor, do hereby authorize adult volunteers of Memorial Baptist Church as agent(s) for the undersigned, to consent to any medical or surgical care deemed advisable by any accredited physician or surgeon in an approved emergency clinic or hospital. I further release from any liability Memorial Baptist Church, any of its ministers or leaders in the event of an accident in route, during and returning from the above mentioned event.

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Signature below: I represent that I am the legal guardian of the child or children on this form and I hereby give Memorial Baptist Church the right and permission, with respect to photographs and videos taken of my child, or in which my child may be included with others, to use, re-use, publish and re-publish the same in whole or in part, severally or in conjunction with other photographs, in any medium and for any purpose whatsoever including illustration, promotion and advertising, social media and trade (excluding anything illegal or immoral).

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Middle school ONLY (6th-8th ONLY): Signature Below: I the parent/guardian/grandparents authorize Memorial Baptist to transport my middle schooler during VBS

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Comments

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