Register a Hero or Shero for Hero Hotline - 2023 Vacation Bible School Participant Name(Required) First Last Nickname The full first name/given name and last/family of the individual who will attend VBSParticipant Preferred Pronouns Grade entering in September 2023(Required)Pre KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeAdult ParticipantThe grade of the individual who will attend VBS or if they are an adult participant.Particpant Birthdate(Required) MM slash DD slash YYYY Participant Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Does the participant have any allergies, limitations, disabilities, or conditions that Covenant UMC or Shorter AMEC staff should be aware of to support them during the VBS experience? Should this individuals's participation be limited for any reason? Is there any additional information about this participant the VBS leaders should know? If so, please explain.Parent/Guardian Name(Required) First Last Parent/Guardian Phone Number (during VBS)(Required) Parent/Guardian Email(Required) Enter Email Confirm Email Email address for parent/guardian where materials and information regarding VBS can be sentAdditional Parent/Guardian Name First Last Additional Parent/Guardian PhoneEmergency Contact Name (available during VBS)(Required) First Last Relationship to Participant Emergency Contact Name (available during VBS and is not Parent/Guardian)(Required) First Last Relationship to Participant Name(s) of the person(s) who may pick up the participant from VBS(Required) Emergency Contact Phone Number (during VBS hours)(Required)Home Congregation(Required)Covenant UMCShorter AMECUnion Community ChurchOther CongregationNot affiliated with a congregation and would be open to learning about these congregationsNot affiliated with a congregation and I don't want more infoHow did you hear about this VBS? Consent(Required) Participation and medical service consent By checking this box, the above named participant may participate in the community Vacation Bible School (VBS) hosted at Shorter AMEC in Morton, PA July 9-13, 2023. I grant permission for staff or volunteers to contact emergency medical services in the event of a medical emergency. Consent Photo/video OPT OUTI understand that Shorter AMEC is a public place and that there will be parents, guardians, staff members, and volunteers taking photographs and videos. Please check this box if you want to OPT OUT of having the above participant included in photographs used by Covenant UMC or Shorter AMEC for their website, social media, newsletters or other ministry related materials. Please note, children's name will never be used with the photos. If you check this box, the participant's face will not be used in photos or video. Δ