When

Monday, June 4, 2018 at 9:00 AM CDT
-to-
Friday, June 8, 2018 at 12:10 PM CDT

Add to Calendar

Where

Grace Church

3312 Calvin Dr
Lawrence, KS 66049

Event Address Map
Driving Directions

Contact

Betty Adema
Grace Church
785-843-2005
betty@gepc.org

VBS 2018 Registration (K - Fourth)

•PLEASE NOTE - CLICK ON THE "ADD CHILD" BUTTON IF REGISTERING MORE THAN ONE KID AND FILL OUT THE INFORMATION FORM FOR EACH. ••CAMP WILDERNESS (5th/6th grade) REGISTRATION is on a separate form.

* Required information

Parent/Guardian Info

  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *

    Are you a regular attender at Grace EPC?

  • *

Parental Consent and Medical Information

  • *
     characters remaining
  • *
  • *
  • *
  • *
  • I, the undersigned parent or guardian of the minors listed above, do hereby give permission for our (my) child(ren) to attend Vacation Bible School activities sponsored by Grace Evangelical Presbyterian Church. I waive any and all rights and claims of any nature I may have against Grace Evangelical Presbyterian Church and any organization connected with any of the events, their representatives, successors, and assigns for any and all injuries or damages of any nature which my child(ren) may suffer while taking part in any event. I will assume all risks of any kind that may befall my child(ren)t as a result of participation in any event. This waiver and release which includes all claims, demands, costs, losses, damages, attorney’s fees and liabilities shall be binding on my heirs, administrators and assigns and run in favor of Grace Evangelical Presbyterian Church. These authorizations shall remain effective through June 8, 2018.

  • I, the undersigned parent or guardian of the minors listed above, do hereby authorize adult workers with the children of Grace Evangelical Presbyterian Church to consent to any examination, x-ray, anesthetic, medical or surgical diagnosis or treatment and hospital care which is rendered under supervision of any physician or surgeon licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. Further, as parent or guardian of the minors named above, I do hereby expressly consent that my son/daughter may receive emergency medical treatment from any physician, hospital, or other medical center without the necessity of first notifying me, and do further agree to hold blameless any physician, hospital or other medical center for rendering such services.

  • *

    I have read the parental consent and the waiver & liability release agreement shown above, and understand the terms used and their legal significance. By Checking the "I agree" box, you are agreeing to the language in the Parental Consent Form. (Consent forms will be kept securely on-site during Vacation Bible School.)

  • *

    Permission for my child/children to be photographed during VBS, and I understand the photos may be displayed in various media formats.

Child Information

  • *
  • *
  • *

    Gender:

  • *
  • *
  • *
  • Food Allergies/Special request (if any)

  •  characters remaining

Registering another? Click "Add" and fill out information for each additional participant.

You may add a maximum of 5

Registration Fees (Camp Wilderness must be payed separately online.)

Item Qty. Max Limit Price

1 Child

Type "1" in the text box to the right.

1 $20.00 each

2+ Children

If you are registering more than one child, type "1" in the text box to the right. Family fees (2+ kids) are $40/max.

1 $40.00 each
$9,999.99

Payment

Payment Method

  • Please make check payable to:
    Grace Evangelical Presbyterian Church
    3312 Calvin Dr
    Lawrence, KS 66049

Payment Summary


Register