I. PARENT INFORMATION and/or ADULT VOLUNTEER INFORMATION

   1.  This section provides ICCC PREP with parent contact information in case IC Staff should need to contact a parent during VBS.  
    2. If parents choose to volunteer, this section captures information about Adult Volunteers preferences and t-shirt sizes.
   3.  CURRENT DOLC SAFE ENVIRONMENT CERTIFICATE MUST BE PROVIDED FOR ALL VOLUNTEERS AGES 18 AND OLDER.​ NO EXCEPTIONS.​

II. STUDENT  ( K-5th Grade)  or STUDENT VOLUNTEER  (6th Grade & Up) 
{ You must fill in the number of students AND/OR student volunteers that you will register in the blank below (1,2, 3, 4) before the form will provide you with blanks to give student  name, age, grade, etc.}

III. Acknowledgement and Consent

A. Parent Consent and Liability Waiver
I am the parent or guardian and  grant permission for my child (children) to participate in Vacation Bible School,  June 12-16, 2023 at Immaculate Conception Catholic Church, 2700 Maplewood Drive, Sulphur, LA 70663.

I do hereby release, absolve, indemnify and agree to hold harmless the Diocese of Lake Charles and Immaculate Conception Catholic Church Sulphur, and their employees, agents, volunteers, and other persons acting on their behalf from all manners of actions, claims which I or the child or children named shall or may have for any reason, arising during my child’s attendance of Vacation Bible School.

B. VBS Emergency Policy
I n the event of an emergency, I hereby authorize Immaculate Conception Catholic Church Sulphur through its authorized representatives, and/or its VBS volunteers to seek emergency medical attention for my child. I understand that I will be notified as soon as possible in the event of an emergency.

I do hereby release, absolve, indemnify and agree to hold harmless  Immaculate Conception Catholic Church Sulphur, and their employees, agents, volunteers, and other persons acting on their behalf from all manners of actions, claims which I or the child or children named above shall or may have for any reason, arising during my child’s attendance of  VBS. 

C.  VBS Photo and Video Policy 
 
I give permission for photographs in which I and my child(ren) appear to be used for publications by Immaculate Conception Catholic Church. This may include use in print, electronic media, social media, including the internet. I understand that parents and volunteers may also be taking photographs and videos for their personal use.