To Mars and Beyond VBS 2019 Volunteer Registration
 
To Mars and Beyond VBS 2019 Volunteer Registration
Your Email Address  * 
Volunteer First & Last Name  * 
Please choose YOUR age from the list:
If applicable, choose the grade level YOU will be entering in Fall 2019:
List any known allergies to medication, environment or food and reaction. (Please answer "NONE" if there are none.) * 
List any medical issues we should be aware of. (Please answer "NONE" if there are none.) * 
Address  * 
City  * 
State  * 
Zip  * 
Main Phone  * 
Secondary Phone
Work Phone
E-mail Address  * 
Church Affiliation
ADULTS (over 18) ONLY: I HAVE ALREADY completed the "Safe Gatherings" program.
ADULTS (over 18) ONLY: I COMMIT TO completing the "Safe Gatherings" program at www.safegatherings.com prior to the start of VBS on June 17, 2019.  * 
I have already completed the program (within the past 3 years).
Primary Emergency Contact Name  * 
Primary Emergency Contact Phone Number  * 
Secondary Emergency Contact Name
Secondary Emergency Contact Phone Number
Name of Authorized Adult who may pick up child(ren) - Adults please respond "NONE"  * 
Phone Number of Authorized Adult who may pick up child(ren) - Adults please respond "NONE"  * 
Name of Authorized Adult who may pick up child(ren)
Phone Number of Authorized Adult who may pick up child(ren)
Choose the grade level you would like to work with:  * 
Choose your first choice for area of service:  * 
Choose your second choice for area of service:  * 
ADDITIONAL INFORMATION:Volunteers participate in recreation and crafts to be held outdoors each day. We strongly recommend you apply sun block prior to arriving. If you think it necessary to have insect repellant, please also apply this prior to arriving. Youth volunteers must be accompanied by at least one other adult at all times.
YOUTH PERMISSION:I hereby give permission for my child to attend the community Vacation Bible School at Whitefish United Methodist Church located at 1150 Wisconsin Avenue. I will not hold Whitefish United Methodist Church or individual staff/counselors liable for such accident or injuries which might occur during the Community VBS. I understand that in the event of an emergency, every effort will be made to notify me; however, in the event I can not be reached, I authorize whatever emergency procedures might be deemed necessary. I authorize Community VBS medical volunteers to administer the medication noted above on this form. Any reservations I might have concerning this release, or any allergies/special issues are noted above on this form.
I AGREE with the above statement as my legal signature of release.  * 
PHOTO RELEASE: Staff and volunteers at Whitefish United Methodist church will be taking photos of the children during the Community VBS. These photos are typically used on our church website and in our newsletter without identifying children by name. Local media may also visit and cover the Community VBS. I hereby give my consent to Whitefish United Methodist Church to photograph my child(ren) and without limitation, to use such photos and or/stories in connection with any of the work of said Community VBS program without consideration of any kind and do hereby release Whitefish United Methodist Church and those represented in the Community VBS from any claims whatsoever which may arise in said regard.
I AGREE with the above statement as my legal signature of release.  * 
 
 
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