Registration for Vacation Bible School 2019
Join us for "God's Creation" Vacation Bible School on June 17-21, 2019! We will be doing so many cool, fun and exciting things as we explore God's creation with one another. All school-age children will meet from 9:00 am-4:00 pm and preschool (ages 3 and 4) will meet from 9:00 am-Noon.

The cost is $40 per person for school age children and $20 each for preschool age, for a maximum fee of $100 per family. Financial assistance is available, if needed. Contact Sharon Hardel for more information. Please submit your payment via check or credit/debit card to the church office or to Sharon Hardel by June 2.

Snacks will be provided throughout the day, but school age children are asked to bring their own lunch each day.

Thank you! We look forward to seeing you at VBS 2019!

Email address *
GENERAL INFORMATION
Name of Child *
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Age *
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Birthdate *
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Grade *
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Tshirt Size (Youth Sizes) *
Emergency Phone *
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1st Parent/Guardian Name *
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1st Parent/Guardian Cell Number *
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1st Parent/Guardian Email *
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2nd Parent/Guardian Name
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2nd Parent/Guardian Cell Number
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2nd Parent/Guardian Email
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HEALTH INFORMATION
Allergies & Reactions?
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Asthma or Diabetes?
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Adaptive equipment, glasses, contacts, hearing aids, etc.?
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List of medications they would normally bring with them on an overnight or day trip:
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Other helpful health-related information?
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IN CASE OF EMERGENCY -- MUST list two people other than parent/guardian listed above!
Name #1 *
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Relationship #1 *
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Phone number #1 *
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Name #2 *
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Relationship #2 *
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Phone number #2 *
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PERMISSION
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ELECTRONIC SIGNATURE
By clicking the "I accept" box below, you are signing this youth registration electronically. You agree your electronic signature is the legal equivalent of your manual signature on this registration.
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TODAY'S DATE *
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Thank you for registering for Vacation Bible School!
A copy of your responses will be emailed to the address you provided.
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