VBS Parents (Step 1): June 24-28, 2024

Upon completion of parent registration (after payment has been processed), you will be redirected to a SECOND registration page where you can enter in child(ren) information!

Please note: You will be required to show a valid driver's license each day when picking up your child(ren). Also, please make sure your list of alternate, authorized pick-up adults is filled out!

Questions? Email Megan Brown in the UPC Office.

* Parent/Guardian First Name

* Parent/Guardian Last Name

* Parent/Guardian Email

* Parent/Guardian Mobile Phone

* Parent/Guardian Address

* Parent/Guardian City

* Parent/Guardian State/Province

* Parent/Guardian Zip/Postal Code

* In Case of Emergency, Contact:

* Emergency Contact Phone #

* Emergency Contact (Relation to Child)

Alternate Authorized Pick-Up Person

Do you attend church regularly? If so, where?

If you are visiting our church, who are you a guest of?

Photo Release Statement

- I grant permission to University Presbyterian Church to take photographs and/or videos of my child(ren). I grant permission for the photos to be used in publications, online, and in other communications related to the mission of University Presbyterian Church and its ministries. You must select 'yes' or 'no' in the field below.

* Photo Release

Medical Release Statement

- I hereby release University Presbyterian Church, the staff, and volunteers from responsibility and liability for any injury or illness that my child may sustain during any event or program affiliated with University Presbyterian Church. In the event of an emergency, I hereby authorize any leader of this activity to act as an agent for me; to consent to any x-ray examination; medical, dental or surgical diagnosis; treatment; and hospital care advised and supervised by a physician, surgeon, or dentist (as appropriate)licensed to practice under the laws of Florida, either at the doctor's office or in any hospital. I expect that every effort will be made to contact me as soon as possible, and that these powers will only be used if attempts to contact me are unsuccessful.

* I have read and agree to the medical release as it pertains to VBS and am providing this digital signature as acknowledgement

Photo Release Statement

Medical Release Statement

Processing registration ...