VBS 2025 Camper Registration Grades K-5 (2190.01P/4320.30YF)

Camper Name

Gender

Grade in 2025-2026 school year

What is your child's t-shirt size? (These are youth tee shirt sizes)

XS S M L XL

Has your child received the sacrament of baptism?

Yep! Not yet!

Allergies/Special Needs? If yes please describe

Parent/Guardian 1 First and Last Name

Parent/ Guardian 1 Phone

Parent/Guardian 1 Email

This address will receive a confirmation email

Parent/Guardian 2 First and Last Name

Parent/Guardian 2 Phone

Parent/Guardian 2 Email

Emergency Contact First and Last Name

Phone

St. Odilia: Photo and Video Release The undersigned grants full permission to use my or the said minor’s likeness in any photographs, videos, or other digital media (“photo”) or any other recorded of this event for any legitimate and legal purpose in any and all of its publications, including web-based publications, without payment or other consideration. I understand that all photos become the property of the parish named above and the Archdiocese of Saint Paul and Minneapolis (ArchSPM), or anyone authorized by the aforementioned parties and will not be returned. I hereby irrevocably authorize parish named above to edit, altar, copy, exhibit, publish, or distribute these photos for any legal and lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.

Yes, I authorize use of my and/or my child’s images as mentioned above. No, I do not authorize the use of my and/or my child’s images as mentioned above.

PARENTAL AUTHORIZATION, RELEASE & INDEMNITY AGREEMENT I, parent or guardian of the above child (ren) grant permission for my child(ren) to participate in this parish/school event. This event will take place under the guidance and direction of parish/school employees and/or volunteers from St. Odilia Catholic Church. I understand and agree that as parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above-named minor (“student/participant”). Further, I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Odilia Catholic Church, its officers, directors, employees and agents, and the Archdiocese of Saint Paul and Minneapolis, its employees and agents, chaperones, or representatives associated with the event and activities (hereinafter “Releasees”), from any claim, including but not limited to all claims relating to communicable disease, arising from or in connection with my child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate Releasees for reasonable attorney’s fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of Releasees and is not related to communicable disease (see communicable disease release, hold harmless and indemnification agreement below). Communicable Disease Release, Hold Harmless & Indemnification Agreement: I agree to hold Releasees harmless, release, defend, and indemnify Releasees for any communicable disease clam arising out of the above Event that is brought against Releasees by myself, participant, my family members, heirs, assigns, executors, and personal representatives. I understand and agree this communicable disease release, hold harmless, and indemnification agreement includes claims based on the actions, omissions, or negligence of participant, myself, and others including but not limited to the Releasees. I HAVE READ THE ABOVE AUTHORIZATION, RELEASE AND INDEMNITY AGREEMENT, ITS DISCLOSURES, AUTHORIZATIONS, AND RELEASES. I UNDERSTAND AND AGREE I HAVE HAD THE OPPORTUNITY TO CONSIDER THE TERMS AND UNDERSTAND THEM. BY SELECTING “YES, I AGREE”, I UNDERSTAND AND AGREE I AM VOLUNTARILY ACCEPTING THESE PROVISIONS WITH FULL KNOWLEDGE OF THE SIGNIFICANCE.

I agree I do not agree

Emergency Medical Treatment: In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment.

I agree I do not agree

I HAVE READ THE ABOVE PARENTAL AUTHORIZATION, RELEASE & INDEMNITY AGREEMENT, ITS DISCLOSURES, AUTHORIZATIONS, AND RELEASES. I UNDERSTAND AND AGREE I HAVE HAD THE OPPORTUNITY TO CONSIDER THE TERMS AND UNDERSTAND THEM. BY MY SIGNATURE BELOW, I UNDERSTAND AND AGREE I AM VOLUNTARILY ACCEPTING ALL THE PROVISIONS WITH FULL KNOWLEDGE OF THE SIGNIFICANCE. FURTHER, I ACKNOWLEDGE AND AGREE THIS ELECTRONIC OR DIGITAL SIGNATURE IS THE LEGALLY BINDING EQUIVALENT TO MY HANDWRITTEN SIGNATURE. By typing your name below, you are signing this form electronically.

Camper Registration

Extra T Shirt

Are you able to volunteer?

Optional Donation. If you would like to make an optional donation to VBS please write in the amount here. Donations will be used for After Hours and for a scholarship for campers to attend VBS.

VBS 2025 Camper Registration Grades K-5 (2190.01P/4320.30YF)

Description

Please Fix the Following