Compassion Camp 2025 VBS BUMC Participant Registration

Compassion Camp 2025 VBS BUMC Participant Registration

Child's last name*

Child's first name*

Preferred name or nickname

Date of birth*

Rising grade*

Enter the grade your child will be starting in the Fall of 2025

Select or enter value

Parent/ guardian full name*

Phone number*

Email address*

Home address*

2nd emergency contact's name*

Provide information for an emergency contact different from parent/guardian (Parent/ guardian will be contacted first)

2nd emergency contact's relationship to child*

2nd emergency contact's phone number*

Allergies?*

Select or enter value

If your child has any allergies, provide details

Describe allergen and associated reaction

Any medical issues that may affect participation*

Describe any medical conditions which may limit your child's participation, e.g., asthma

Must medication be given during VBS hours?*

Only physician prescribed medication will be given and only if the medication cannot be given outside the hours of VBS. (A BUMC Staff member will reach out for more information)

Select or enter value

Doctor's name and phone number

Permission to administer basic first aid*

By selecting yes, you are giving permission for a staff member of BUMC to administer basic first aid to your child.

Select or enter value

Behavioral or learning needs?

If your child has any behavioral or learning issues that may interfere with their ability to participate fully in VBS, provide the details and any interventions/ methods that will help mitigate these issues.

Any special language considerations?

Individuals authorized for pick up (Full name)*

Describe any additional support that's necessary

Permission for child to participate*

By checking the box, you are giving permission for your child to participate in VBS activities under the supervision of BUMC Staff and Volunteers.

Consent to use photos/ videos

By checking the box, you are consenting to the use of your child's image through photos or videos in BUMC communications.

Special requests for grouping of children

If you would like your child to be assigned to the same group as another child, please enter the other child's name here. You may enter more than one. While every attempt will be made to honor your requests, there are circumstances, such as the number of participants in a specific age group, which may prevent us from honoring all requests.

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