2025 VBS: Hearts on Fire

We're excited to welcome you to our VBS! It's going to be a fun week of learning, playing, and getting fired up for God!

Mark your calendars:

Monday, June 16, 2025 - Friday, June 20, 2025

Programming runs from 9AM - 12:30 PM; you may drop off your child as early as 8:30 AM, and pick up as late as 12:30pm.

A parent or guardian is required to attend all sessions with children under age 5.

Child's Name

Preferred Pronouns

Registering as:

Camper (Kindergarden - 6th grade) Counselor (Entering 7th Grade and up) Little one (under 5) attending with a parent/guardian

Birthdate

Grade in Fall 2025

Parent/Guardian Name

This address will receive a confirmation email

Phone

Address

Primary Emergency Contact (Name, Relationship, Phone Number)

Other Adults Authorized to Pick up Child (Bring ID)

Medical Authorization

In the case of an emergency, I understand that St. Paul’s will make attempts to contact me and/or another person listed above. If no one can be reached in a timely manner, I hereby give my consent to emergency first aid, medical examination, X-ray, anesthetic, medical, dental or surgical diagnosis, treatment and care rendered by or under the general or special supervision of licensed medical personnel.

I have read and understood the above statement & give my consent for medical treatment

Yes

Are there any medical conditions or allergies our VBS staff should know about?

Please list any medications you will be sending with your child

Does your child require any accommodations to attend and enjoy camp?

My child would benefit from a 1:1 adult or teen buddy for the week Yes, please call me to discuss No thanks

Photo Release

I hereby grant permission for St. Paul’s Episcopal Church, Benicia, CA and/or The Episcopal Diocese of Northern California, of which it is a member congregation, to record sounds, images or video of my child(ren) during the event known as Vacation Bible School to use in church and/or diocesan publications, marketing and promotional material, and on respective websites, along with corresponding information. Photos used in the above mentioned means of communication will NOT include my child’s name, address or phone number.

Choose one:

I AM authorizing use of my child's image I AM NOT authorizing the use of my Child's image

Payment and Scholarships

The cost of VBS is $60 per camper; counselors attend for free.

Payment can be made by cash or check at the church office or here by credit card. Checks can be dropped in the church mail slot at any time, or put in the plate on Sunday morning.

Checks should be made out to St. Paul's Episcopal Church with "VBS" in the memo line.

Payment

Do you require a scholarship to attend? If yes, the Rector will follow up with a phone call.

Yes No

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2025 VBS: Hearts on Fire

Description

Please Fix the Following