Register to Volunteer at VCS Questions? Contact Gloria Knopp at 412.441.3800 x122 or GloriaK@coh.net. VCS Youth Volunteer Form Step 1 of 3 33% Youth Volunteer InformationFor youth under the age of 18.Name* First Last Email What's the best phone number to reach you?*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Have you received a COVID-19 vaccine?* Yes No Have you lived in Pennsylvania for 10 years or more?* Yes No What's your age?*Please enter a number from 10 to 17.What's your date of birth?* Month Day Year What grade did you most recently complete in school?*Please enter a number from 5 to 12.How will you get to and from VCS each day?* Please list the names of people who are authorized to pick you up. Who is your emergency contact?* First Last What is the best phone number to reach your emergency contact?*Do you have any special needs or allergies? If so, please list them. Volunteer PreferencesHow do you prefer to receive information?* Email Postal service I would like to volunteer with age group: Select All Preschool Kindergarten Grade 1 Grade 1 Grade 3 Grade 4–5 What are your activities of interest? Worship Teaching Teacher assistant Recreation Music Crafts Snacks Afternoon activities Wherever needed What days are you available?* Monday, June 24 Tuesday, June 25 Wednesday, June 26 Thursday, June 27 Friday, June 28 What hours are you available?* All day 8 am–12 pm 12–3:30 pm Youth Volunteer Permission SlipTo be completed by a parent or guardianPhoto Consent I give East Liberty Presbyterian Church permission to use photos of the student listed on this form and to put the finished photos to any use (newsletter, bulletin boards, website) without limitations or reservation.In Case of Emergency I understand that every effort will be made to contact me. If I cannot be reached, I hereby give the East Liberty Presbyterian Church Vacation Church School Workers the permission to act on my behalf in seeking emergency treatment for my child in the event that such treatment is deemed necessary by the Vacation Church School (VCS) workers. I give permission for those administering emergency treatment to do so, using those measures deemed necessary. I absolve the VCS workers and East Liberty Presbyterian Church from liability in acting on my behalf in this regard so long as the VCS workers are not grossly negligent.Parent or Guardian Name First Last Parent or Guardian Cell NumberParent or Guardian Work Phone NumberParent or Guardian Home Phone NumberCAPTCHANameThis field is for validation purposes and should be left unchanged.