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Participant Registration

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Faith Evangelical Free Church, Acton MA

Location

54 Hosmer St.

Acton, MA 01720

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Contact Dina Webb:

978-263-0075

vbcatfefc@gmail.com

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Address 1

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Address 2

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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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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup Phone

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Church you typically attend:

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How did you hear about our VBC?

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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

First Name

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Last Name

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VBC is open to children who turn 4 by July 15, 2024 through entering 5th grade in the fall.

Date Of Birth

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Grade Entering

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Gender

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Allergies

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Medical Concerns

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Is this your first time participating in our Vacation Bible Camp at Faith Church?

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If no, how many times have you joined us for VBC?

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Were you specifically invited by someone? If so, who?

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A NOTE ABOUT PLACEMENTS: We place children into "Crews" of up to 5 participants of mixed ages, rather than by age or grade. That crew then rotates to different stations each day with several other crews in their "Group". If we are unable to place children in the same Crew, we try to place them in the same Group. We give priority to placement requests of those children who are new to our VBC and/or may not know any of the other children, so that they feel comfortable and welcome. ***Please note that campers age 4 through entering Kindergarten participate in a separate program during camp.

Do you have a friend you would like to be placed with? If so, who? (Please list no more than 3).

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Please add any additional information about your child that will help us better encourage them and meet their needs.

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I have read and agree to the following MEDICAL AND LIABILITY RELEASE: In case of a medical emergency I hereby give my full consent to the leaders of Faith Evangelical Free Church to seek and provide medical emergency treatment as needed for the participant named above. I hereby release all claims for injuries or damages in excess of automobile insurance coverage incurred while driving to or from or participating in all events sponsored by Faith Evangelical Free Church.

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I have read and agree to the following PHOTO/VIDEO RELEASE: I acknowledge that the participant listed on this form may be photographed or captured on video during the Vacation Bible Camp program. I hereby grant permission to Faith Evangelical Free Church to use the images/videos of listed participants for in-house slide shows, crew pictures (to be printed and sent home with each camper) and photos of large groups. Only photos of large groups will be placed on the church website. Personal identifiable information will not be released or posted.

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I have read and agree to the following HEALTH GUIDELINES: I acknowledge that the participant listed on this form will adhere to all current health protocols in place during VBC. I also understand that my child will be asked to remain at home if he/she is sick or has a fever, or is required to isolate.

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