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Vacation Bible School Registration
Tippett's Chapel Free Will Baptist Church
2530 Shotwell Road Clayton, NC 27520

When: July 8 - 11
Time: 6:15 PM - 8:45 PM
Ages: 3yrs old to 5th grade (completed)
Cost: FREE

Child's Name *
Your answer
Age *
Your answer
Last Grade completed (as of July 1, 2018) *
Your answer
Special Needs or Allergies *
Your answer
Parent/Guardian Name *
Your answer
Email *
Your answer
Address:
Your answer
Emergency Contact Number *
Your answer
Please provide up to 2 additional people allowed to pick up your child other than listed above
Name:
Your answer
Phone Number:
Your answer
Relationship:
Your answer
Name:
Your answer
Phone Number:
Your answer
Relationship:
Your answer
**Your child/children's safety is very important to us. In order to best service our parents, we have added a new Security Procedure for our 2018 VBS program for Drop Off & Pick Up. Please submit up to two additional people you give permission to pick up your child at the end of VBS each night (8:45pm). Everyone is required to show a picture ID at time of Pick up. Therefore, anyone you have designated to pick up your child from VBS must match the child's name tag. NO one will be able to pick up your child without proper ID.
I have read the new Security Rules for Drop Off and Pick Up Procedures *
Required
I approve photos of my child to be used on Tippett's Chapel Facebook page and/or website. *
Required
How did you hear about us?
Your answer
Thanks for Registering! We look forward to seeing you at Camp Moose on the Loose!
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