2023 STELLAR VBS TEEN VOLUNTEER SIGN-UP Youth Name(Required) First Last Parent/Guardian Name(Required) First Last Parent/Guardian Name First Last Are you a member of St. Sebastian Church?(Required) Yes No Adult Cell Phone Number(Required) Youth Cell Phone By entering this cell phone number, parent gives permission for us to text or call their youth to give information about VBS, if neededYouth Email By entering this email, parent gives permission for us to email their youth to send information about VBS. Where do you wish to help? You may check more than one.(Required) Sing & Play Blast Off AND Cosmic Closing Helper Imagination Station Helper All-Star Games Helper Stellar Bible Adventure Helper Crew Leader (Responsible for 3-5 kids in a larger group of 15-20) Substitute (fill in where needed) T-Shirt Size Youth Small Youth Medium Youth Large Other opportunities to assist with preparation before VBS I can help with donations, call or email me. Scenery- help prepare props and items needed by painting backdrops, making signs, preparing crafts, ect. if I’m available on the dates you set up Prepare materials at home Setting up hall July 13-14 Time TBD Clean up immediately following the event, Thursday July 20 Grade Entering in the Fall6th7th8th9th10th11th12thFreshman Year of CollegeMedical Treatment Release SUBMIT Agreed and accepted As the parent or legal guardian, BY CLICKING “SUBMIT” BELOW I hereby authorize first aide/medical treatment for my youth(s) who is/are listed above in the event of an emergency which may endanger her/his life, cause disfigurement, physical impairment, or undue discomfort if delayed. It is understood that efforts will be made to contact the emergency contact person listed on this form as soon as reasonably possible. In the event that my youth(s) requires my authorization for treatment and I cannot be reached in an emergency, I hereby give my permission to the physician selected by the activity leader to hospitalize, secure medical treatment, and/or order an injection, anesthesia or surgery for my youth(s) as deemed necessary. Furthermore, BY CLICKING “SUBMIT” BELOW I understand all reasonable safety precautions will be taken at all times by the parish and its agents during youth programing and events. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree to waive and release, and indemnify and hold harmless Saint Sebastian Church, any and all affiliated organizations, its/their employees, agents, representatives, volunteers and drivers, from any and all claims my child may have, excluding claims for intentional misconduct or gross negligence, arising from or relating to my child’s participation in this event.Allergies or other Medical Please list any allergies or other information we should know about. Emergency Contact Person's Name(Required) Emergency Contact Persons' Phone(Required) Relationship to Youth(Required) Physician's Name(Required) Physician's Address(Required) Physician's Phone Number(Required) Name of Health Insurance Company(Required) Insurance Policy/Group Number(Required) Insurance Contact Number(Required) Photo Permission(Required) I DO grant permission to use photos/videos of my child(ren) I DO NOT grant permission to use photos/videos of my child(ren)
