2024 Bothell Kids VBS Registration Form

We're looking forward to a wonderful week with your child(ren).

This year we are working with the Hibulb Cultural Center on the Tulalip Reservation for a Vacation Bible School focused on the history, lore, crafts, songs, prayers, art, traditions and current concerns of the Coastal Salish tribes that lived in this area. Rising 4-6^th graders have options of hikes, service projects and a field trip, all off-site.

The cost for camp is $40/kid. The field trip is $20 extra. Camperships are available to help with costs. Simply email Susanna Griefen at sgriefen@bothellumc.org or call (425)486-7132 before completing this form.

Please complete one form per child.

Adult's Information

Adult's Name

This address will receive a confirmation email

You will receive emails about Kids Camp VBS from kids@bothellumc.org. Be sure to update your email preferences so they don't end up in your junk folder. I would also like to receive weekly emails from Bothell Kids @ Bothell UMC with worship resources and ways to engage. I would also like to be added to the Bothell UMC general email list to receive updates about the church and it's activities.

Phone

Address

Child's Information

Child's First & Last Name

Preferred pronouns:

She/Her He/Him They/Their Other (please note below)

If other:

Date of Birth

Grade in Fall

Allergies (food, environment, medicine, etc.):

Yes No

If yes, please explain:

Please choose the craft kit you would like to order for your child. The first is free, extras may be purchased.

Dreamcatcher - $6 ea Cedar Paddle Necklace - $8 ea. Woven Cedar Mat - $10 ea.

Rising 4-6th graders have the option of off-site hikes, service projects and a field trip to the Hibulb Cultural Center. Please mark which they will attend. Permission slips will be sent home. Monday hike Tuesday service project Wednesday hike Thursday field trip. $20 will help defray the bus rental cost. Friday reflection walk. I can help chaperone.

Is there anything we should know about your child to ensure a positive experience? (special accomodations/supports, medications they will bring with them, likes/dislikes)

We celebrate the gifts and talents of children of all abilities. For children who would benefit from having a “buddy” accompany them to our activities, please let us know. Buddies are trained volunteers who understand and implement strategies to encourage participation as well as offer alternative activities if they are needed (i.e., quiet play, take a walk, etc.) Other accommodations are available as needed.

Additional Information

Emergency Contact (name, relationship and phone number):

Who is authorized to pick up your child in addition to you and the emergency contact:

Photo & Video Release: I hereby consent to and give my permission to Bothell United Methodist Church to use my child’s picture, voice, and likeness in its programs and activities, including the advertisement and promotion of same. Parent/Guardian Initials

Medical Release: I authorize a church staff or adult leader, in whose care the minor has been entrusted, to consent to any x-rays, anesthetic, medical, surgical, or dental diagnosis or treatment. Also, any hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital. Whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. I assume responsibility for any expenses incurred and understand that our insurance will be the primary insurance to be used in the event of an emergency. I understand that the church and/or adult ministry leader cannot be held responsible. I understand that the church staff and adult leaders will do everything within their ability to ensure the safety of my child while in their care. Parent/Guardian Initials

Camp is fun for adults too! If you would be willing to be part of the camp community by helping, we would LOVE to have you! We will be in touch with you soon if you select an option below! I am interested in helping in person as a group leader one day or more I am interested in being an Assistant teacher one day or more I am interested in supervising games I am interested in greeting/monitoring at entry and exit times and other logistical tasks, in person I can't help in person but would like to help in another way We have a youth age kid (entering 7th grade and older) that would like to help. Please list names and ages below.

Youth volunteer names, ages and how they would like to help.

2024 Bothell Kids VBS Registration Form

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