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VBS Registration 2017
Registration for participants of Hillyer Memorial Christian Church Vacation Bible School, July 31 - Aug 4, 2017, 9am-noon.

This year Hillyer's VBS is for children ages 3 years through rising 3rd graders. We will explore the gifts GOD has given each one of us and learn ways we can use our gifts to make the world a better place. On Tuesday morning during VBS parents are encouraged to join us as we take a trip to the NC Museum of Art!

Registration closes on July 24, 2017.

Please contact Susan Gray at children@hillyerchurch.org or (919) 832-7112 if you have questions.

Parent/Guardian name(s)
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Parents/Guardian mobile phone number(s)
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Parent/Guardian email address(es)
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Parent/Guardian mailing address(es)
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Child's name
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Child's age as of August 1, 2017
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Child's date of birth
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List any special needs or allergies, including food allergies:
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If you have other children attending from this family, please list their registration information here including name, age, date of birth, and special needs or allergies
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Provide the name and phone number for an emergency contact if the parent cannot be reached
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If anyone other than a parent is picking up the child after VBS, please list the person's name and phone number
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As evidenced by my e-signature below, I understand that my child will be transported to the North Carolina Museum of Art from Hillyer Memorial Christian Church on Tuesday, August 1 as part of the VBS curriculum. I understand that the church and its representatives will make every effort to keep my child safe and secure. I hereby give my permission for my child to be involved in this activity and will hold harmless the church, camp volunteers, and the church personnel for any accident that might occur. I also understand that every effort will be made to contact parents / guardians of the youth in case of an emergency. In the event that I cannot be reached, I hereby give permission to the physician selected by the camp volunteers/ church personnel to hospitalize, secure proper medical treatment for, and/or to order any injection, anesthesia, or surgery for my child that is deemed essential for their well-being.
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Insurance Provider and Policy Number
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