Vacation Bible School Registration Form
We are so excited that you are choosing to send your child to our free Vacation Bible School Jerusalem Marketplace: A walk with Jesus. We will walk the streets of Jerusalem at our church from 6:30 pm - 8:30 pm on Sunday June 26th through Thursday June 30th. It will include daily lessons, snacks, visits to the marketplace, barnyard animals, amazing songs, and so much more.

Please join us for a Family Fun Afternoon on Saturday June 25th 1-4 pm for some fun, inflatables, and special surprises, too!

Your friendly neighborhood church,
Beaver Assembly of God
500 Dutch Ridge Rd Beaver, PA

PS Please fill out one form for each child.

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Email *
Parent/Guardian's Name *
Child's Full Name *
What school year has the child just finished? *
Street Address *
City *
State *
Zipcode *
Does the child have any dietary restrictions? *
Any special needs we need to be aware of? *
Who has your permission to pick up the child? *
Emergency Contact Name: *
Emergency Contact Phone Number *
Media Release: I understand that at this event or related activities, my Child may be photographed. I agree to allow my Child’s photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers and assigners. When an identification of a child is made, only the first name of the child may be used along with the name of the church. *
Consent to Medical Treatment: I hereby give my consent that my Child may receive medical treatment from any medical personal that may be deemed advisable in the event of injury, accident and/or illness during this Event. *
A copy of your responses will be emailed to the address you provided.
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