Family Name* Number of Children (Must be at least 4 years old to register)1234Child 1 - Name* Child 1 - Grade for upcoming school year*---Pre-KK12345Tshirt size*XSSMLXLAdult MAdult LChild 2 - Name* Child 2 - Grade for upcoming school year*---Pre-KK12345Tshirt size*XSSMLXLAdult MAdult LChild 3 - Name* Child 3 - Grade for upcoming school year*---Pre-KK12345Tshirt size*XSSMLXLAdult MAdult LChild 4 - Name* Child 4 - Grade for upcoming school year*---Pre-KK12345Tshirt size*XSSMLXLAdult MAdult LPrimary phone*Secondary phoneEmail* Medical InformationMedical Consent** Yes - I consent No - I do NOT consent; I will provide an alternate plan to the Director of Children’s Ministry before camp begins. *Medical Consent I hereby allow the above-mentioned child(ren) to participate in all activities associated with VBS. As the parent/guardian of these registered children, I hereby permit and authorize the leaders of St. Andrew United Methodist Church Vacation Bible Camp to call a doctor for medical or surgical care for my/our child(ren), should an emergency arise and I cannot be reached. I release St. Andrew and the adult leaders from responsibility and liability for any occurrence resulting from such treatment. I further agree to accept the full responsibility for any such medical treatment or cost as the above-authorized action might incur.Allergies or other medical conditions/concerns:Child's Physician's Name & Phone Number* Medical InsurancePlease upload a photo or scan of your insurance card, OR enter the information belowUpload Insurance CardMax. file size: 1,000 MB.If you uploaded your insurance card, you may skip the three questionsInsurance Company Policy Number Group Number Hospital Additional Emergency Contact and Phone Number* COVID Protocol Consent* I/we agree to adhere to all COVID protocols established by St Andrew UMC and implemented for camp health safety. * Current COVID protocols include: The wearing of masks over the nose and mouth at all times. Stay home if unwell or exposed to someone with COVID-19. Wash hands thoroughly between activities. Updated Covid protocols will be communicated to families by Children’s Ministry Director before camp start date.Consent to photo and video use for social media and church publications.*Please note that participants may appear in a music recording for the St Andrew virtual Sunday worship service which can be viewed publicly on St Andrew’s You Tube channel. Names of children are not published. If you wish for your child NOT to appear on camera please contact the program administrator. I consent Friends are welcome!We will do our best to honor ONE friend request per child to be in the same age group as your child. I have a friend request for one of my children I have friend requests for each of my children Friend's Name First Last Grade level Your child's name Friend's Name First Last Grade level Your child's name Friend's Name First Last Grade level Your child's name Friend's Name First Last Grade level Your child's name Friend's Name First Last Grade level Your child's name Parent VolunteersNOTE: Registration fee for children of full-time volunteers is waived. Only $10 payment for each t-shirt ordered is required. I would like to serve as an adult volunteer. Please contact me. I have received the COVID 19 vaccine Parent/Guardian Signature* Your child WILL NOT be registered until payment is received. Please complete payment in the next step.