2025 SMCC VBS Registration

SMCC has a rich history of youth leadership development through its VBS program. We ask all youth leaders to take time to apply to a position on the youth leadership team by answering the questions below. Applying does not guarantee a position on the youth leadership team. Priority goes toward applicants who show maturity in character and faith, along with aspirations for leadership development.

Because we have limited positions and value cohesive community, please note the following:
**We prioritize youth who are invested in our SMCC church community in some way (i.e. church on Sundays, youth group, service opportunities, and other church events)
**We are unable to accept middle schoolers as volunteers unless we already have a relationship with them.
**high schoolers from outside our church community are considered on a case by case basis

We look forward to your responses and to working with you more closely!

First & Last Name

Grade Entering

6th 7th 8th 9th 10th 11th 12th other

Name of School

Date of Birth

Address

Student Cell Phone

Student Email

This address will receive a confirmation email

Have you ever had the opportunity to participate in a VBS before?

YES: BOTH as a participant and a leader YES: As a Leader only YES: As a participant only No.

Please choose one of the following that best represents your thought about this sentence. It is easy for me to prioritize spiritual formation in my own life.

Very true Somewhat true Somewhat untrue Untrue

Reflect in 3-5 sentences about a spiritual formation activity that is meaningful to you.

Why do you want to apply to be a leader for VBS 2025?

Is there something you specifically would like to help lead during VBS? (This question is optional)

Parent/Guardian

Parent/Guardian Email

This address will receive a confirmation email

Parent Phone

Emergency Contact

Emergency Contact Relationship

Emergency Contact Phone

Health or Special Needs (check as appropriate)

I have no special health needs that the staff should be aware of and is /are not on any kind of medication. I have the following allergies/special need(s)

Allergies (example: epilepsy, heart trouble, diabetes, etc. Please provide specific instructions including current medication, frequency, and dosage)

Doctor's Name

Doctor's Phone Number

Health Insurance Company

Policy Number

Regarding San Marino Community Church's permission to use my image in any media publications, electronic or printed.

I do grant permission I do NOT grant permission

Program Leader Contract - We/I understand that program leaders are expected to act in behaviors that appropriately represent SMCC and its mission in ministry. Therefore behavior that is disruptive, poses a threat to the leader or others, or that exhibits an inability or unwillingness to control his/her impulses will not be tolerated. In the event that a youth leader exhibits these behaviors, SMCC staff will have a conversation with the leader about further participation in the program.

Electronic Signature

Please have your parent read and sign:

Waiver/General Release for a minor - I (above named parent), in the event that I and my co-parent are unreachable, authorize(s) San Marino Community Church, (please print name) it’s agents, employees, officers, directors and volunteers (herein known as SMCC) in whose care the minor child has been entrusted by me/us, to consent to any x-ray examinations, anesthetic, dental or surgical diagnosis or treatment and hospital care to be rendered to the minor under the general care and special supervision of a licensed physician under the California Medical Practice Act and/or by a licensed dentist. It is understood that this authorization is given in advance of any special diagnosis, treatment or hospital care being required. It is given to provide authority and power on the part of SMCC to give specific consent to any and all such diagnosis, treatment or hospital care which a treating physician and/or dentist in the exercise of his/her best judgment may deem advisable in the event of illness or injury of the minor child. This authorization is given pursuant to the provisions of California Family Code, Section 6901-6910. This authorization shall remain in effect through September 30, 2025 unless sooner revoked by the undersigned in writing delivered to SMCC. This also releases SMCC, it’s agents, employees, officers, directors and volunteers (herein known as SMCC) from any and all costs and expenses, including but not limited to, attorney’s fees, reasonable investigative and discovery costs, court costs, and all other sums which SMCC may pay or become obligated to pay on account of any, all and every demand for, claim or assertion of liability or any claim or action founded for, arising or alleged to have arisen out of the activity for which this authorization is given or the use of real property belonging to SMCC by any action or omission by the minor child. Liability Release: I/We agree to waive all claims against SMCC, it’s agents, employees, officers, directors and volunteers harmless from any and all liability claims that may arise out of or in connection with my child’s/children’s participation in this ministry and its activities. Transportation Release: I/We are aware that students will be transported to and from events in a church, and/or rental and/or private vehicles. A completed (signed and returned) Field Trip Permission form will be mandatory for any event where minors will be transported off campus. Insurance Release: I/We understand that SMCC’s insurance begins where the individual’s health and accident policy terminates. Personal Belongings Release: I/We understand that SMCC is not responsible for personal belongings (including but not limited to cell phones, clothing, etc.) Discipline Release: I/We fully understand that each participants are to abide by all rules and regulations governing conduct during the various activities/trips. In the event of repeated student misconduct, I/We authorize the staff to send my child home at my (parent’s/guardian’s) expense.

Electronic Signature

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2025 SMCC VBS Registration - LEADER

Description

2025 SMCC VBS Registration - LEADER

Description

Please Fix the Following