Hillsdale Vacation Bible School 2017
Join us for VBS August 7th to 11th from 9am to noon at 349 Hillsdale Avenue Hillsdale, NJ
Pre-K-5th grade. Child care for toddlers available upon request. Children older than 5th grade work as volunteers.
LIMITED ENROLLMENT! You may not get a spot! If you prefer a paper form please download here:
https://drive.google.com/file/d/0B1DvPr60rOTRTjd1Vml5MVV4Z1U/view?usp=sharing
Our Vacation Bible School is action packed! See the preview video right here!
Parent/Guardian Name
Please include Mother, Father and Last Names
Your answer
Home Address
Street, City and Zip Code
Your answer
Phone Number
Home, Work and Cell Numbers are appreciated
Your answer
Name of Church you attend
If you have no home church please leave blank
Your answer
VBS and Hillsdale United Methodist Church
Please check the box for "yes"
Child's Gender
Child's Name
List only one child (please fill in form a second time for more than one child)
Your answer
If possible, with what friend would you like your child to be placed?
Your answer
Birthdate
month/day/year
Your answer
Grade completed as of June 2017
Your answer
Photo Release
By filling out this form you are authorizing Hillsdale United Methodist Church to use photos and video as part of the slideshow wrapping up each day of VBS. You are also authorizing the use of photos and video for publicity. If this is a concern, please email the church office.
Registration Fees
The first child registered will cost 30 dollars. Each additional child registered costs 15 dollars. Your registration is not complete until payment is made. Please mail a check to 349 Hillsdale Avenue Hillsdale, NJ 07642 for the appropriate amount made out to Hillsdale United Methodist Church Attn: VBS, or pay by cash, check or credit card at the church, or by calling in with your credit card information. You can also pay online by clicking the link below. Please mark "VBS" along with your child's name in the Special Collections section.

https://goo.gl/idLYKP

Non-parental Pick-up
Advance written notice must be provided if anyone other than the parents listed are to pick up your children from VBS.
Emergency Medical Information
Please note that VBS staff cannot dispense any medications to your children
Medical Release
Required
Date of last tetanus shot
month/year
Your answer
Alternate Contact
Name, relationship and telephone number
Your answer
Known allergies
please note that a healthy snack will be served as part of the program
Your answer
Medical conditions or other pertinent information
Your answer
Child's Physician
Name, address and telephone number
Your answer
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