We're excited for this Summer's VBS program! We have officially closed registration, but if you're still interested in attending VBS, you may place your child on the waitlist by filling out the registration form. **PLEASE SKIP THE PAYMENT PAGE. Thank you!

When: July 31st thru August 4th, 9am-12pm 
Who: 4 year-olds to incoming 6th graders
Where: American High School Campus
Cost: $25 per child; scholarships available


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Child's First Name *

 
{{answer_Zbtc}}'s Last Name *

 
{{answer_Zbtc}}'s Date of Birth *

 
{{answer_Zbtc}}'s Age *

Minimum age requirement of camp attendees is 4 years old by 7/25/16. Must also be fully potty-trained.
 
Home Address *

(street address, city, state, zip)
 
Your First Name *

 
Your Last Name *

 
Your relationship to {{answer_Zbtc}} *

Ex. Mother, Father, Grandmother, Aunt, etc.
 
Your Phone Number *

 
Emergency Contact Name & Relationship to {{answer_Zbtc}} *

ex. Jane Doe (Aunt)
 
Emergency Contact Phone Number *

 
Any food allergies, dietary restrictions, or medical conditions we should be aware of? *

 
{{answer_Zbtc}}'s T-shirt Size *

Youth Sizes (XS, S, M, L, XL)
 
We want all of our families to feel involved in our VBS program! How would you like to lend your God-given gifts to our efforts?


 
IMPORTANT - PLEASE READ & SIGN THIS RELEASE FORM 

In case of any accident or illness during VBS activities I agree to release Resonate Movement, its employees and volunteers from all liability. I consent to any x-ray, examination, anesthetic, medical or surgical supervision and on the advice of any physician or surgeon licensed to practice in the state of treatment, when the need for such treatment is immediate, and when efforts to contact me are unsuccessful. I agree to pay for said treatment and will hold Resonate Movement, its affiliates and members harmless from liability. In addition, Resonate Movement and its affiliates may take and use photos and or videos of participants for publicity purposes. Photos and videos of our participants are used in promotional materials, including their website, Facebook, other media, e-newsletters and any other marketing publications. I hereby grant Resonate Movement and its affiliates permission to use my, or my child’s, likeness, name, voice and words in any broadcast, telecast or print media account of this event or activity free of charge.  
I, the [parent/guardian] for this registration, warrant the truthfulness of the information provided in this application. *Please type your first and last name which serves as an ELECTRONIC SIGNATURE.** *

Type Full Name Below:
 
Registration fee for {{answer_Zbtc}} {{var_price}}

 
Please enter your Credit or Debit Card number:

 
The CVC number:

(3 or 4 digit security number on the back of your card)
 
The name on your card:

 
Your card's expiry month:


 
Your card's expiry year:


Thank you for registering! We're looking forward to this Summer's VBS and pray that {{answer_Zbtc}}'s relationship with Christ will be richer because of it! Please keep an eye out for email messages with helpful instructions as we get closer to VBS. If you're interested in serving at VBS, please visit our sign up link at www.resonatemovement.org/vbsstaff. See you this Summer!
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