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VBS Registration

- Parish Life

Please complete the online registration form.
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- Parent\Guardian Name REQUIRED Please fill out this field. Please enter valid data.
- Parent\Guardian Name REQUIRED Please fill out this field. Please enter valid data.
- Child Name 1 REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Child Name 2 Please enter valid data.
- Date of Birth Please enter valid data.
- Child Name 3 Please enter valid data.
- Date of Birth Please enter valid data.
- Child Name 4 Please enter valid data.
- Date of Birth Please enter valid data.
- Address REQUIRED Please fill out this field.
- Home Phone Number Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.
- E-mail Please enter valid data.
- Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Food Allergies Please enter valid data.
- Other Allergies Please enter valid data.
- Other pertinent information
- Photo Permissions REQUIRED
  During Vacation Bible School, we take pictures that appear on the church website, Facebook, and newsletter. These are put within these medias without names. Please indicate if this is acceptable or not.
  Please fill out this field.
- Archdiocese of Cincinnati
  Permission, Release, and Authorization to Seek Medical Treatment
  
  1. By checking this box, I give permission for my child to participate in the activity described in the  Activity Information form   and release from all liability and indemnify the Archbishop of Cincinnati, Archbishop of Cincinnati, both individually and as trustee for the Archdiocese, all parishes and schools within the Archdiocese, and their respective officers, agents, representatives, volunteers, and employees,  the Bishop of Columbus individually and as trustee for the Diocese of Columbus, St. Peter parish, and all parishes/schools and their representatives from any and all liability, claims, judgments, cost and expenses, including attorney's fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from the activity and further agree not to bring or prosecute or allow to be brought or prosecuted (including but not limited to prosecution through subrogation) in my name, or on behalf of my child, any claims, lawsuits, or actions against the the Archbishop, the Archdiocese, the Bishop, the Diocese, and their officers, agents, representatives, volunteers, and employees.
  
  2. I further understand that my child's participation in this activity  is purely voluntary and is a privilege and not a right, and that my child, and I, on behalf of my child, agree to my child's participation in the Activity in spite of the risks.
  
  3. I agree to instruct my child to cooperate with the Archbishop or his agents in charge of the activity.
  
  4.  I appoint the Archbishop or his agents who are acting as leaders of the activity to seek medical treatment of my child in the event of any injury, illness, or medical emergency occurs during the activity or related travel. I understand that the agents of the Archbishop will make a reasonable attempt to contact me as soon as possible in the event of a medical emergency involving my child.
  
  5. I agree that the Archbishop or his agents may use my child's portrait or photograph or video for promotional purchased, website and office functions and use social media and technology to communicate to my child regarding ministry related activities.
  
  6. This acknowledgement and release is intended to be as broad and inclusive as permitted by the law of the State of Ohio and if any portion hereof is declared invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This acknowledgement and release shall be construed in accordance with the laws of the State of Ohio, except for the choice of law provisions thereof.
  
  I have carefully read and understand and accept the terms and conditions state herein and acknowledge that this Permission, Release and Authorization to Seek Medical Treatment shall be effective and binding upon me, my child, and my own and my child's personal representative or estate, assigns, heirs, and next of kin and that I have signed this agreement of my own free will.
  
  By hitting agree, you accept the terms and conditions that have been stated above. A hard copy of this may be obtained from the parish office at St. Peter Church (285 W. Water Street).
- I agree REQUIRED Yes No Please fill out this field.
- Signature of parent/guardian confirms agreement to liability release as well as permission for child(ren) to attend REQUIRED
  Cost of VBS - $10 per child / $20 per family. Please pay at the parish office. If this would be a financial burden, then please contact the parish office.
  Please fill out this field. Please enter valid data.
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