VBS Volunteers 2017 Form
July 10th-14th, 9am-12noon
Name:
____________________________
Age (if under 18): _____________
Address: _________________________
___________________________
Home Phone #: _______________________
Cell Phone #: ________________________
Email Address: __________________________________
T-shirt Adult size: S M L XL 2XL 3XL
Please Check your area of Interest:
( ) Snack Donations: Chex cereal, Gold Fish, Animal crackers,
gummy worms, small pretzel sticks, mini marshmallows, small 6-inch
flour tortillas, mozzarella string cheese, pizza sauce, graham crackers,
whipped topping(like cool whip), semi-sweet chocolate chips, cinnamon
and sugar tortilla chips (Walmart), fresh strawberries, blackberries and
blueberries, Yoplait go-gurts vanilla flavored, shredded coconut,
( ) Supply Donations: Plastic cups, plastic bowls, small paper plates,
plastic knives, plastic spoons, sandwich-size sealable bags, quart-sized
sealable bags, hand sanitizer, anti-bacterial hand wipes, rubber bands,
bags of ice
( ) Babysitting: Leader Assistant
( ) ClassRoom: Leader Assistant Grade preferred: ______
( ) Office Help: attendance, class changes, copies, hall monitoring
( ) Arts & Crafts: Leader Assistant
( ) Music: Leader Assistant
( ) Bible Story: Leader Assistant
( ) Games: Leader Assistant
( ) Building Decoration: Leader Assistant
( ) Clean up & Set Up crew: Leader Assistant
( ) Snacks: put together, serve, and clean up
( ) Any position, Help where needed
I, ______________________________ (parent’s name if participant is under 18), give
permission to my above named son/daughter/myself to assist with Vacation Bible School at
St. Luke Catholic Church in Temple, TX July 10th-14th 2017. If needed for health reasons, I
give permission for my child/self to be evaluated, diagnosed, treated, and/or given medication
in accordance with the standard medical practice by licensed medical personnel. I relieve St.
Luke Catholic Church, its staff members and volunteers of all responsibility and consequence
that may arise as a result of this treatment. I will not hold St. Luke Catholic Church, its
personnel, or volunteers liable in the event of injury. Further, I agree to accept any and all
financial responsibility as a result of scheduling medical treatment. My child/self agrees to
abide by all the rules and regulations stated by St. Luke Catholic Church and the FF/VBS staff. I
understand that St. Luke Catholic Church will not be liable if my child/self fails to cooperate
with regulations, and that any infraction of the rules may result in immediate dismissal from
the activity at my expense. Photos and videos of participants will be taken as a part of VBS.
Participants signature: _____________________________ Date: ________________
**ANYONE older that 16 yrs. old, MUST be up to date with Ethics & Integrity according to the
Diocese of Austin. Please see me if you need to find a workshop to go to for certification!**