Palma Ceia Presbyterian Church

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STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

KNIGHTS OF NORTH CASTLE

Palma Ceia Presbyterian VBS 2020

June 1-5

9 a.m. - 12 p.m.

Cokesbury's VBS 2020, Knights of North Castle: Quest for the King’s Armor, invites children to be strong in the Lord and in the strength of God’s power by exploring how we put on the armor of God. Kids will take on the role of brave Knights and begin their quest each session by opening the King’s Book, where they’ll explore Old and New Testament stories.

Vacation Bible School is open to kids who will complete Pre-K 4 (age 4 on or before September 1, 2019) - 5th grade by May 31, 2020. Scholarships are available - email nancyc@palmaceia.org for information.

A completed Pre-K 3 (age 3 on or before September 1, 2019) class is available for full time adult VBS volunteers, and the registration fee applies, as they receive the same supplies. Choose the Pre-K 3 Adult FT Volunteer tab under current grade. Don't forget to select the area you'd like to volunteer in for the week under Volunteer Information a few sections below. Volunteers with children in the Pre-K 3 class must be on campus for the week.

Nursery care for under Pre-K 3 completed (age 3 or under after September 1, 2019) is available for full time adult VBS volunteers at no cost. To include your Nursery-aged child without being charged, do not include them in the initial quantity drop down menu, but DO include them under the CHILD INFORMATION section. Choose the Nursery Adult FT Volunteer tab under current grade. Don't forget to select the area you'd like to volunteer in for the week under Volunteer Information a few sections below. Volunteers with children in the Nursery must be on campus for the week.

Questions? Contact Kerri Edwards or Jess Hayden at vbs.pcpc@gmail.com

Qty

Description

Amount

Total

Child Registration(s)

$50.00

---

per child

Family Registration

$125.00

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per family 3-4 children

Registration is not complete until your payment is successfully processed. You will receive an email confirmation immediately upon successful completion.

For all cancellation requests through May 18, 2020 there will be a $25 cancellation fee (per family) deducted from any approved refund. Cancellation and refund requests must be made in writing and a check will be mailed to the Parent or Guardian address provided. Beginning May 18, 2020, registration fees are non-refundable, as supplies for your child will have been purchased by then, but we would appreciate if you would notify Palma Ceia Presbyterian if your child will not be attending.

Total: $0.00

Child Information

Please enter your child's information below. Click the green tab "Add Additional Child" to register more than one child.

Child #1 Last Name: *

First Name (Preferred): *

Age: *

Date of Birth: *

Current Grade 2019-20: *

School:

Gender: *

T-Shirt Size: *

Friend Request:

(maximum 2 - not guaranteed)

Known allergies/medical conditions/special needs:

Parent/Guardian Information

Parent/Guardian #1: *

Parent/Guardian #1 Email: *

Parent/Guardian #1 Phone: *

Parent/Guardian #1 Address: *

City: *

State: *

Zip Code: *

Parent/Guardian #2:

Parent/Guardian #2 Email:

Parent/Guardian #2 Phone:

Church Home:

Questions/Comments:

Additional Information

Emergency Contact: *

(other than custodial parent/guardian)

Emergency Phone: *

Is your child covered by medical/hospitalization insurance? *

Physician Name & Phone:

Insurance Company Name:

Insurance Phone:

Insurance Group/Policy #:

MEDICAL CONSENT

I/we hereby authorize any hospital, clinic, physician, doctor, nurse, or technician to furnish my child, named above, any medical care and treatment necessary as a result of any injuries sustained or other emergency medical care treatment as the circumstances require during all onsite activities and events (referred to as “events”), including while being transported from and back to the church and while at the place of destination. I/we hereby authorize representatives of Palma Ceia Presbyterian Church (PCPC) to retain or acquire said medical care and treatment on my behalf if I cannot be reached by phone or there is not time or opportunity to make such a call. I/we also authorize PCPC to provide emergency transportation for my child. I/we agree to be responsible for payment of any and all medical treatment, services, or transportation rendered. I/we understand that PCPC does not provide any guarantee of medical confidentiality or transportation of my/our child to a specific physician or medical care facility.

LIABILITY RELEASE

I/ we do hereby agree, for my child and my child’s heirs, parents, guardians, representatives, successors, and assigns, to fully release, discharge, hold harmless, indemnify, and defend PCPC, its officers, administrators, trustees, staff, representatives, employees, contractors, volunteers, agents, affiliates, and insurers (“Released Individuals”) from and against any and all injuries, damages, claims, actions, expenses, liability, or losses of any kind to, or caused by, me or my child arising out of or in any way related to obtaining or providing medical treatment or emergency transportation for my child. I acknowledge that this release shall waive all rights by me, my child, or anyone acting on our behalf, individually or collectively, to pursue relief for injuries, damages, or losses against the Released Individuals in any forum and under any theory; including, but not limited to, theories of contract and tort. I further agree that this release unequivocally is intended to waive all claims against the Released Individuals due to any cause, including their own negligence or gross negligence. This release is effective as of the date written below and is to be construed according to the law of Florida. This release may be modified only in a writing signed by both me and an authorized representative of PCPC. I have executed this release freely and voluntarily and without duress or coercion of any kind. I further represent that I have been given adequate time to review this release and that I completely understand the language used in it as well as the rights waived by my signature. If any portion of this release is found invalid or overbroad by a court of competent jurisdiction, I agree that the remaining portions shall continue in full effect, or that the release will be modified to the minimum extent required to ensure validity, as appropriate.

I/we have read the Medical Consent and Liability Release, and understand and voluntarily agree to these provisions, with the signature of one parent/guardian acting as an agent for both.

VBS PERMISSION TO PHOTOGRAPH / VIDEO

I grant permission to PCPC to photograph or videotape my child at VBS and to publish, reproduce, and distribute such photos or videos in church publications, social media, and understand if declined, my child will not be able to be in the closing program on Friday.

Permission to Photograph/Video: *

CHILD COVENANT (for your child)

I promise to be a faithful member of the community gathered. This means that I'll be respectful to all adults and children, listen to all instructions given, and be excited to be part of our activities. I understand that I am representing my church, my family, and God, and if I do not act within event expectations and in a respectful way at any event, my parents may be called, and I may not be able to remain at the event.

I have discussed this with my child.