VBS Registration 2017


VBS June 26 – 30 5:45 pm – 8:00 pm

Ages: 4yrs. – rising 6th gr.

Please register each child 4yrs – Rising 6th Grade below and complete the Release Form.


Rising 1st– 6th graders will attend the same sport selected throughout the week.

4yrs – Rising K will play in an assortment of recreational games throughout the week.


Father's Information


Mother's Information


Emergency Contact Information


Children's Information

Child 1



Child 2



Child 3



Child 4



Child 5




This is to certify that I am familiar with St. Giles Presbyterian Church and its general activities and do hereby agree to hold the church harmless in the event of any injuries sustained in individual or corporate activities, on and off the property at 2027 Emerywood Drive; including field trips and retreats.

I hereby release St. Giles Presbyterian Church from any claims and demands that may occur during participation in church activities.

In the event of an accident or illness that requires medical treatment while participating in this activity, I understand every effort will be made to contact me or other family members. In the event we cannot be reached, I hereby grant permission to the adult leadership to act in our behalf in seeking emergency treatment for our child/children listed below. I absolve the church involved from liability so long as they are not grossly negligent.

This release form will be valid for the following children until December 31, 2017.


Insurance Information (Optional)