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VBS One Day Fun Day registration

VBS One Day Fun Day

Saturday, June 12

Drop-Off: 9:00am 

Pick-Up: 2:00pm

Ages 4 (or turning 4 by Sep. 1) to rising 5th grade

Covenant Presbyterian Church

Please register by May 28.

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Home Address*


Must be able to show photo ID!

Must be able to show photo ID!

Multiple children must live in the same household and under the care of the same parent/guardian.


Grade Entering in the Fall

If your child has no allergies, simply type 'N/A'


Grade Entering in the Fall

If your child has no allergies, simply type 'N/A'


Grade Entering in the Fall

If your child has no allergies, simply type 'N/A'

Consent and Release

I hereby grant permission for my child or children listed on this form to participate fully in all Covenant Presbyterian Church 2021 Vacation Bible School (“VBS”) activities and programs. I specifically release Covenant Presbyterian Church and its officers, employees, and volunteers from any and all liability as to any right of action or claim to relief, including negligence, that may accrue either to my child for any injury or damage that my child may suffer while participating in activities and programs of Covenant’s VBS.

Photo Authorization 

I authorize Covenant Presbyterian Church to use my child’s image in photographs, videos, or other digital images from VBS activities in print, electronically, or on websites. Authorization for Alternate Person to Pick Up Child/Children. I authorize Covenant Presbyterian Church to release my child to any person listed on this form as an alternate person authorized for pick up.

Child Behavior Agreement

I also agree that in the event my child contravenes the activity rules, instructions, or regulations of the adult leaders in charge, I will drive to the site of the activity to bring
my child home.

Child’s Health Agreement

My child is in good physical condition at the present time, and has not had any serious illness or operation since the last examination by a physician. If my child is not well at the time of any activity of Covenant’s VBS, I will not let my child attend.

COVID-19 Health Agreement 

In an effort to keep our children and volunteers safe, we will take the temperatures of all volunteers each morning upon arrival. By signing this form, you are recognizing that your child has not experienced any COVID-19 symptoms (or been generally sick) in the past two weeks. Please check your child's temperature before sending him/her to VBS.

If your child does begin exhibiting symptoms, you will be contacted and asked to pick up your child immediately.

Statement of Allergies All of my child's allergies have been provided in the form above.

Request for and Agreement to Pay for Medical Treatment 

In the event of illness or accident in the course
of any Covenant VBS activity or program, I hereby request and authorize such medical personnel as selected by the adult leaders in charge to institute without delay such measures as the judgment of the medical personnel
dictates for the health of my child. I agree to pay for all medical care given to my child. I understand that if time allows, VBS personnel will try to contact me, but may not be able to do so.