VBS Registration 2019 June 24-28th 9-11 a.m. at the Eaton Community Church, 3 y.o.-Kinder grads
Please use this form to register your child(ren) for Vacation Bible School.

Dates: June 24-28th
Time: 9AM-11AM
Where: Eaton Community Church (formerly First Congregational Church of Eaton), 1561 Benjamin Drive
Ages: 3 years (potty-trained) through Kindergarten Graduates

Contact Information
Parent/Guardian Name *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Alternate Phone Number
Your answer
Emergency Information
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Physician Name *
Your answer
Physician Phone Number *
Your answer
Safety Information
Consent *
By completing and submitting this form, I give permission for my child(red) to participate in Vacation Bible School (VBS) at the Eaton Community Church and any activities related to VBS. I also authorize VBS staff to obtain emergency medical treatment in my absence, and release the Eaton Community Church, it's staff, and VBS leaders of all liability and claims. Please type your name below if you agree.
Your answer
Relationship To Child(ren) *
Security: is there anyone who your child(ren) should NOT be released to? *
Your answer
May we use pictures or video of your child(ren)? *
If your child(ren) are in any of the pictures or videos that we take, do you grant us permission to use them for publicity, illustration, advertising or web content? No names will be used.
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