Vacation Bible School Release Forms 2026

The below information is required for your child to attend the St. Matthew Lutheran Church Vacation Bible School. Included: Parental Consent Form and Medical Release Form - Form MUST be filled out separately for each child.

Parent/Guardian Name: Parent/Guardian Name: First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Child's Name Child's Name First Last
Age
PHOTO RELEASE FORM - 2026 VBS
This form allows you to consent to certain items regarding your child’s enrollment at St.
Matthew Lutheran Church & Early Childhood Center VBS, including a release of photographs.

While attending VBS, your child will be photographed and video-recorded by a variety of
people and in a variety of situations. This form is intended to both notify you of these activities
and to request any necessary permission.
Parents, students, staff, media, the public and others are permitted and authorized to
photograph and/or video-record certain events/activities. Anyone in attendance at such an event
shall have no reasonable expectation of privacy. St. Matthew Lutheran Early Childhood Center
may use photographs and/or video of anyone present at such an event on any of the media
sponsored by St. Matthew Lutheran Early Childhood Center, including, but not limited to:
newsletters, website, Facebook, etc. St. Matthew Lutheran Early Childhood Center is not
responsible for how others may use any such recordings they may make. No consent is needed
from parents/guardians and no additional notice will be provided by St. Matthew. Any student
(or student’s parent) who objects to being photographed or video-recorded, upon timely written
request, may be excused from participation in any such event.

Please select below: I Grant or I Do Not Grant:
my permission for St. Matthew Lutheran Church & Early Childhood Center to photograph
and/or video-record or publish (or release to media) my child’s name in connection with the
publication of any photograph or video of my child. I understand that, if I do not grant my
permission, my child may be excused from participation in any such event. I understand that a
written request must be submitted to the office in a timely manner to ensure my child will be
excused from the participation in an eventParent Permission

PHOTO RELEASE FORM - 2026 VBS This form allows you to consent to certain items regarding your child’s enrollment at St. Matthew Lutheran Church & Early Childhood Center VBS, including a release of photographs. While attending VBS, your child will be photographed and video-recorded by a variety of people and in a variety of situations. This form is intended to both notify you of these activities and to request any necessary permission. Parents, students, staff, media, the public and others are permitted and authorized to photograph and/or video-record certain events/activities. Anyone in attendance at such an event shall have no reasonable expectation of privacy. St. Matthew Lutheran Early Childhood Center may use photographs and/or video of anyone present at such an event on any of the media sponsored by St. Matthew Lutheran Early Childhood Center, including, but not limited to: newsletters, website, Facebook, etc. St. Matthew Lutheran Early Childhood Center is not responsible for how others may use any such recordings they may make. No consent is needed from parents/guardians and no additional notice will be provided by St. Matthew. Any student (or student’s parent) who objects to being photographed or video-recorded, upon timely written request, may be excused from participation in any such event. Please select below: I Grant or I Do Not Grant: my permission for St. Matthew Lutheran Church & Early Childhood Center to photograph and/or video-record or publish (or release to media) my child’s name in connection with the publication of any photograph or video of my child. I understand that, if I do not grant my permission, my child may be excused from participation in any such event. I understand that a written request must be submitted to the office in a timely manner to ensure my child will be excused from the participation in an eventParent Permission I Grant Permission I Do Not Grant Permission
I understand that I may elect to revoke my consent at any time notifying the VBS Coordinator.
Parent/Guardian Signature:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
MEDICAL RELEASE FORM - 2026 VBS I, (Parent/Guardian’s Name) hereby give permission for any and all medical attention to be administered to my child, (Child’s Full Name) in the event of accident, injury, sickness, etc. under the direction of the person(s) listed below, until such time as I may be contacted. I also assume the full responsibility for the payment of any and all expenses incurred in connection with such treatment. The release is effective for St. Matthew Lutheran Church VBS July 20, 2026 - July 24, 2026 from 9AM-12PM Parent/Guraidan Name: MEDICAL RELEASE FORM - 2026 VBS

I, (Parent/Guardian’s Name) hereby give permission for any and all medical attention to be administered to my child, (Child’s Full Name) in the event of accident, injury, sickness, etc. under the direction of the person(s) listed below, until such time as I may be contacted. I also assume the full responsibility for the payment of any and all expenses incurred in connection with such treatment. The release is effective for St. Matthew Lutheran Church VBS July 20, 2026 - July 24, 2026 from 9AM-12PM

Parent/Guraidan Name: First Last
Child's Full Name Child's Full Name First Last
INSURANCE INFORMATION
Company Name:
Policy/Contract Number:
Group Number:
Phone Phone - ### - ### ####
PHYSICIAN INFORMATION
Name:
Phone Phone - ### - ### ####
MEDICAL CONDITIONS
Known allergies:
Medical conditions:
Special needs:
Medications being taken:
If I cannot be reached, any of the following persons are designated to act on my behalf:
Please include: Name, Title, Phone for each person listed.
CONSENT FOR MEDICAL TREATMENT As the parent/legal guardian of the above named child, I hereby give my consent for emergency medical care prescribed by a duly licensed hospital, Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent. CONSENT FOR MEDICAL TREATMENT
As the parent/legal guardian of the above named child, I hereby give my consent for emergency medical care prescribed by a duly licensed hospital, Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent. First Last
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Please provide a copy of your insurance card (both front and back)