2017 Vacation Bible Camp Registration Form

Registration Dates: April 24 - June 9, 2017

Camp Dates:  July 10-14, 2017

9:00 a.m. - Noon Daily

1 child - $45

2 children - $55

3 or more children - $60

Family Last Name
Parents' First Names
Parent Email
Street Address
City
State
Zip Code
Primary Phone
Cell Phone
Emergency Contact Name
Emergency Contact Phone Number

Are you a registered member of St. Andrew by the Bay?

If you would like to request your child be placed in the same group as another child (including a sibling), please specify below:
Student's Name
Grade Entering 2017-2018
Date of Birth
Age

My child requires an Epi-pen

Allergies / Special Circumstances / Other Special Requests
Student #2 Name
Grade Entering 2017-2018
Date of Birth
Age

My child requires an Epi-pen

Allergies / Special Circumstances / Other Special Requests
Student #3 Name
Grade Entering 2017-2018
Date of Birth
Age

My child requires an Epi-pen

Allergies / Special Circumstances / Other Special Requests
Student #4 Name
Grade Entering 2017-2018
Date of Birth
Age

My child requires an Epi-pen

Are you able to volunteer in the following areas (check all that apply):

Note: All volunteers must be STAND certified.

If volunteering, will you need child care for a child age 6 months to 4 years old?

If yes, please specify name and age of child(ren) needing child care.

Archdiocese of Baltimore Permission Form and Release

In consideration of the wholesome recreational and learning experience in which my child(ren) will participate, I as parent or guardian of my child(ren), do hereby agree to allow my child(ren) to participate in Vacation Bible Camp from July 10-14, 2017 at St. Andrew by the Bay.
 
In consideration of the opportunity for my child(ren) to participate in the program, I agree to RELEASE AND HOLD HARMLESS AND INDEMNIFY St. Andrew by the Bay, the Roman Catholic Bishop of Baltimore and his successors, a Corporation Sole, and all their agents, servants and employees from any liability, claims, demands and causes of action arising out of or relating to any loss, damage or injury sustained in connection with or arising out of my child(ren)'s participation in the program.
 
Parents/guardians of participants are advised that photographs or videotape of participants may be used in publications, websites or other materials produced from time to time by St. Andrew by the Bay (Participants would not be identified, however, without specific written consent).  Parents/guardians who do not wish their child(ren) to be photographed or filmed should so notify the Division in writing.  Please note that the Division has no control over the use of photographs or film taken by media that may be covering the event in which your child(ren) participate(s).

After you hit the submit tab, please be patient and wait for the "thank you;" it may appear to be frozen, but it takes a few minutes to process.