Motlow Creek Baptist Church

Where faith grows and hearts connect

2300 Motlow Creek Road
Campobello, SC 29322

Summer Youth Olympics 2025 Registration

Parent/Guardian Information

Please provide your contact information. This will be used for all children in this registration.

First Name*

Last Name*

email*

Primary Phone Number*

Alternate Phone Number

Address Line 1*

Address Line 2

City*

State*

ZIP Code*

Child Information

Provide information for each child attending VBS. Children must be 5 years old and potty trained.

First Name*

Last Name*

Date of Birth*

Class in Fall 2025*

School

Medical Information

All medical information is kept confidential.
Leave blank if not applicable

Allergies

Include food allergies such as tree nut, peanut, etc.

Dietary Restrictions

Include medical diets such as no dairy, etc.

Emergency Medical Conditions

Include required Emergency Medicines such as EpiPens, Inhalers, etc.

Emergency Medical Information

Important: If your child has any life-threatening allergies or medical conditions that require immediate attention, please also contact the SYO Director at (864) 978-3494 before the first day.

Emergency Contact Information

Please provide at least one emergency contact who can be reached if we are unable to contact you directly.
This person should be authorized to pick up your child if needed.

First Name*

Last Name*

Phone*

Relationship to Child*

Consent & Permissions

Just two quick checkboxes to complete your registration!

Opt-Out of photos/video Release(check if you do not want your child in photos)

I agree to the Terms & Conditions*

Privacy Notice

We collect this information solely for VBS registration and safety purposes. Your data is not shared with third parties and is deleted after the program ends.