Fields marked with an
* are required Personal Information
T Shirt Size
Please check this box if you will be requiring afternoon care. Afternoon care is offered from 2:00-5:30 Monday - Thursday for an additional cost of $5 per day per camper. If this box is selected, you will receive an email from Laura Melton, our Director of Children's Ministries, with additional information.
District of Columbia
Zip / Post Code
Parent / Guardian Name
Emergency Contact and Number
Home church (if not GLC)
How did you hear about GLC's day camp? (i.e. a friend, Facebook, church)
General Health Information
Chronic or recurring illness or medical condition that may affect Day Camp life:
Allergies (i.e. food allergies, bee stings, etc.)
Dietary restrictions (i.e. vegetarian, lactose intolerant)
Other suggestions that may help make your day camper's week more comfortable and enjoyable
Medications (please list kind and dosage)
All pertinent medication must be brought to the local Day Camp Director in their original containers.
Date of last Tetanus
I give my permission for my child to participate in all aspects of the Day Camp program. I understand that every effort will be made to contact me if my child needs emergency medical treatment. I authorize medical personnel, the local Day Camp coordinator or Day Camp staff to secure any medical or emergency treatment as deemed necessary for my child. I or my insurance company will pay for any medical treatment if costs are incurred. I give permission for any picture or video taken of my child to be used for promotional purposes.
Parent / Guardian Signature
What does the G in GLC stand for?
Day Camp Covenant
As a participant in Day Camp and as a child of God, I understand and agree to the following expectations:
I will choose to participate fully in Day Camp.
I will choose to respect all people, including myself, choosing to treat others as I would like to be treated
I will choose to listen to the Day Camp leadership team and volunteers.
I will choose to use my words to build others up or I will choose to be quiet.
I will not bring harm to myself. I will choose to maintain self-control.
I will choose to be respectful of the facilities and grounds where Day Camp is held. I understand that if I damage other peoples' property, I am responsible for replacing/repairing it.
I understand that if I choose to break this Conduct Covenant, there are consequences. I will take responsibility for my actions. I understand that if I choose to harm myself or others, my parent/guardian will be contacted and I will be sent home.
Day Camper Signature
I have read this Conduct Covenant and enter into it with my child. I will encourage my child to abide by it. I understand that should my child choose to break this Covenant, every effort will be made to contact me and my child will be sent home. I also understand that if I am not reachable the emergency contact listed will be contacted.
The registration fee for VBS is $15 for the week plus $5/day for aftercare for a maximum cost of $35. You may make checks payable to Gilbert Lutheran Church and mail or drop off at the church during business hours (9:00-3:00 Tuesday through Friday) - 135 School St. PO Box 270 Gilbert, IA 50105. Or you can pay at drop off on June 17th. If you have any questions, please enter them in the field below and we will reply by email. Thanks!