King of Glory, Dallas Texas

VBS 2022 (In-Person @ KoG Only)

Child's First Name •

Child's Last Name •

Child's Date of Birth •

Gender •

Male
Female

Address •

Address (cont.)

City •

State •

Zip •

Parent/Guardian Name •

Best Contact # During VBS (Cell phone preferred) •

Parent/Guardian Email Address •

How old will your child be on September 1, 2022?

My child is in preschool •

Each preschool class has 10 spots available. If the preschool class you are registering for is closed and you would like to be placed on a waiting list, please send an email to Rainey Smith at rsmith@kingofglory.com. If enough children are on a waiting list, a new class will open up for registration and you will be notified, so please email me.

Your child's completed elementary grade? •

Does your child have any allergies, food restrictions, medical or special needs which we need to be aware of in order for him/her to have a great VBS experience? •

No
Yes

If yes, please explain in detail.

Event Admission

Early Bird Price: $20 per child and $50 (3+ kids). If you are registering 3+ kids, make sure to NOT select Yes - Family price more than once. There is an option to choose No - Adding a child to my (3+ kids) registration. If you have questions, please call Miss Rainey at 972-661-9435. Early Bird Price Ends on July 1st.

If a parent or guardian volunteers to work VBS for the entire week, their child/children can attend VBS for free! Please be sure to complete the volunteer registration if you would like to take advantage of this special offer.

Would you like to participate as a volunteer? If yes, please complete the separate Volunteer Registration page. •

Do you need a scholarship? •

Yes
No

Online Payment •

If you would prefer to pay by cash/check, please pay in person to Rainey Smith.

Cost includes one t-shirt per person and one CD per family. CDs will be available for pickup on June 27th.

The deadline to guarantee a t-shirt size is June 1st.

T-shirt Size •

Guests

If your child is attending with a KoG friend, please note that children will be in age/grade specific small groups. Non-KoG children attending with a KoG friend will be placed in the same group if ages/grades are similar. Please help us be consistent by not requesting that your child be placed outside of his/her age/grade group.

Name of KoG friend.

Does your child attend a church other than King of Glory?

If yes, which church?

Emergency Contact Information

Please list the name of a person other than yourself that can assist in the event of an emergency.

Emergency Contact Name & Relationship •

Phone Number •

Do you authorize KoG to publish pictures and names of yourself and/or your child on KoG Website and Social Media articles? •

Yes
No

I understand that KoG will use my child's pictures for VBS projects. •

Yes

Liability Release

We (I), in consideration for our child/youth attending King of Glory Children, Youth, and Family Ministry activities and being under the age of 21, do hereby release, forever discharge and agree to hold harmless King of Glory Lutheran Church in Dallas and the directors thereof from any and all liability, claims of demands for personal injury, sickness of death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant that occur while said child is participating in King of Glory Children, Youth, and Family Ministry trips and activities.
      Furthermore, we (I) [and on behalf of our (my) child-participant] hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation and related activities involved therein.
      Further, authorization and permission is hereby given to said church to furnish any necessary transportation, food and lodging for this child.
      The undersigned further hereby agree to hold harmless and indemnify said church, its directors, employees and agents, for any liability sustained by said church as a result of negligent, willful or intentional acts of said child, including expenses incurred attendant thereto.
      We (I) are the parent(s) or legal guardian(s) of this child, and hereby grant our (my) permission for her (him) to participate fully in King of Glory Lutheran Children, Youth, and Family Ministry activities, and hereby give our (my) permission to take said child to a doctor or hospital and hereby authorize medical treatment, including but not in limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any.
      Further, should it be necessary for the child/youth to return home due to medical reason, disciplinary action, or otherwise, we (I) hereby assume all transportation costs.
      Further, we (I) agree to allow King of Glory to use any photographs or video of my child for the purpose of King of Glory publicity.

Either or both parents must sign.  If divorced or separated, custodial parent or legal guardian must sign.  This form is valid for a period covering March 1, 2021 - February 28, 2022.  Electronic signature is accepted by clicking "I Agree".

I Agree •

VBS 2022 in Dallas, Texas

King of Glory, Dallas Texas

VBS 2022 (In-Person @ KoG Only)

Event Admission

Guests

Emergency Contact Information

Event Information

Contact Information