Summer Activities Registration

My child plans to attend(Required)

Vacation Bible School – June 5-8 | Rising kinder-rising 5th graders

Creative Camp – June 26-June 30 | Rising 2nd-rising 6th graders

Mission Kerrville(Full with waitlist) – July 10-14 | Rising 2nd-rising 6th graders

Participant Information

Participant Full Name(Required)

First Last

Nickname (if applicable)

Child's Date of Birth(Required)

Grade for 2023-2024 School Year(Required)

Participant’s Shirt Size(Required)

Describe Your Child’s Swimming Abilities(Required)

Parent/Guardian Information

Parent(s) or Guardian(s) Name(Required)

First Last

Home Address(Required)

Street Address City State ZIP Code

Home Phone

Cell Phone

Work Phone

Parent Email(Required)

Secondary Email

Emergency Contact 1(Required)

Emergency Contact 1 Phone(Required)

Emergency Contact 2(Required)

Emergency Contact 2 Phone(Required)

I would like to be a chaperone and/or provide transportation for one of the activities(Required)

Yes

Which activity can you help with?

Vacation Bible School

Creative Camp

Mission Kerrville(Full with waitlist)

The following individuals may pick up my child: (please list name and phone number)(Required)

Photo Release Information

I give First Presbyterian Church of Kerrville permission to use my child’s photo in the following publications

The local newspaper

The church newsletter

The church website

I do not give First Presbyterian Church of Kerrville permission to use my child’s photo in any publication.

Parent Signature(Required)

Submitted as digital signature

Name

Date(Required)

Today’s date

Permission, Release and Medical Information Form

As parent or legal guardian, I give permission for my child to participate in the church’s planned summer activities, June 2022 through August 2022. I have been given a schedule of events through the summer, including where the group is going, when they will leave and when they will return. I realize that the children will be transported to and from the church in the church bus or in privately owned vehicles as needed. I understand that my child will be properly supervised and all reasonable precautions will be taken to ensure their safety. Only adult advisors/chaperones will be allowed to drive, and everyone will be required to wear seat belts at all times while traveling. Nevertheless, I realize that there are risks inherent in trips such as these, and I agree not to hold First Presbyterian Church, its staff or volunteer advisors/chaperones responsible for any accident that may occur on this trip.

I give permission for medical treatment to be administered should it be necessary for the welfare of my child. I understand that reasonable efforts will be made to reach me by phone before any medical treatment is authorized, but emergency care will be administered without delay.

Insurance Company(Required)

Participant Plan/Group/ID Number(Required)

Adult Name under which the child is insured(Required)

Known Food Allergies(Required)

Known Drug Allergies(Required)

Current Medications(Required)

Medical Conditions(Required)

Please provide us any additional information about your child if necessary.

Parent Signature(Required)

Submitted as digital signature

Name

Date(Required)

Today’s date

Name

This field is for validation purposes and should be left unchanged.

Registration Form for 2023 Summer Activities

First Presbyterian Church, Kerrville, Texas

Participant Information

Parent/Guardian Information

Photo Release Information

Permission, Release and Medical Information Form