2023 Vacation Church Camp Registration

Parent Name

This address will receive a confirmation email

Phone

Please consider volunteering for VCC 2023. As a volunteer, you will receive a $5 discount for each day you volunteer. The discount can be applied below as you go to submit payment. Click HERE to fill out the volunteer registeration form for any part of the week.

Participant(s) Information

Child 1 Name

Age on June 5th

T-shirt size

Allergies

Additional information you would like us to know

Child 2 Name

Age on June 5th

T-shirt size

Alergies

Additional information you would like us to know

Child 3 Name

Age on June 5th

T-shirt size

Allergies

Additional information you would like us to know

Child 4 Name

Age on June 5th

T-shirt size

Allergies

Additional information you would like us to know

Waiver and Release

I swear or affirm that I am the parent or legal guardian of the following child(ren):

As the parent or legal guardian, I have the authority to enter into this Waiver and Release on my child(ren)’s behalf. I hereby release St. Spyridon Orthodox Church (“St. Spyridon”) from any and all liability or claims which may arise while my child(ren) participate in activities at Vacation Church Camp (“VCC”) on the premises of St. Spyridon . I understand and acknowledge that this release discharges St. Spyridon from any liability or claim that I may have against St. Spyridon and its employees, agents, officials, and volunteers, with respect to any injury or illness that my child(ren) may sustain, as well as any damage to mine or my child(ren)’s property, or any other claim that may arise from my child(ren)’s participation in VCC. Please indicate your agreement by typing your full legal name below.

Medical Treatment: I hereby release and discharge St. Spyridon and its employees, agents, officials, and volunteers, from any claim whatsoever which arises from any first-aid treatment or other medical services rendered in connection with any urgent or emergency medical situation while my child(ren) are participants at VCC. Please indicate your agreement by typing your full legal name below.

Photographic/Video Release: I grant permission to St. Spyridon to use any and all photographs, videos, or audio recordings of my child(ren) attending VCC for the purposes of advertising, promotion, and/or curriculum publication. Please indicate if you agree, or if you would like to opt out of this release for your child(ren) by checking the appropriate box below

I agree I do not agree

Payment

First, select how many many total children you are paying for. Then, select the appropriate volunteer discount based on the number of days you are volunteering.

1 Child

2 Children

3 Children

4 Children

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2023 Vacation Church Camp Registration

Description

Please Fix the Following