Geist Christian Church VBS - July 8-12 - Promise Road Campus
Child MUST be 4 years old by August 1, 2019 - no exceptions

9:00am-12:00pm daily*

*Join us Friday for a family picnic and program at 12:00pm.
Please bring a sack lunch to enjoy following a short program.
FREE treat will be served as well!

***FEES***
1st child: $25 2nd child: $15 3rd child: $10 ***no household will pay over $50***
Register before Memorial Day (Monday, May 27) & receive a $5 per family discount

***PAID REGISTRATION MUST BE RECEIVED BY JUNE 19TH TO ENSURE A T-SHIRT***

If an ADULT volunteers the ENTIRE week - your immediate family will attend for free - must submit an adult volunteer form

If you or an older child would like to volunteer; please fill out a Volunteer Registration Form

Child #1 First Name *
Your answer
Last Name *
Your answer
Date of Birth (MM/DD/YYYY) *
MM
/
DD
/
YYYY
Gender *
Required
Age/Grade entering Fall 2019 *
T-Shirt Size - Youth *
Child #2 First Name
Your answer
Last Name
Your answer
Date of Birth (MM/DD/YYYY)
MM
/
DD
/
YYYY
Gender
Age/Grade entering Fall 2019
T-Shirt Size
Child #3 First Name
Your answer
Last Name
Your answer
Date of Birth (MM/DD?YYYY)
MM
/
DD
/
YYYY
Gender
Age/Grade entering Fall 2019
T-Shirt Size
Please indicate: *
Church Home
Your answer
Parents/Legal Guardian *
Your answer
Home Street Address *
Your answer
City & Zip Code *
Your answer
Cell Phone *
Your answer
Home Phone
Your answer
Email *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Relationship *
Your answer
Please list any special needs/food or other allergies/medical conditions for each child you are registering.
Your answer
Special Requests: Children are placed in age/grade-appropriate groups. We will do our best to accommodate request, but may need to limit class sizes for the safety of our children and volunteers.
Your answer
I am the legal guardian of the child/children listed on this form and give permission for such child to attend VBS at Geist Christian Church from July 8-12, 2019. I understand that my child/children will learn about the Bible and the good news of Jesus Christ. Further, I hereby authorize representatives of GCC, when I am not present with my child at VBS, to consent for all reasonable and necessary medical treatment and procedures which are required for the child/children listed on this form. I understand that in such an emergency, reasonable attempts would first be made to contact me, time and conditions permitting and that in any event, I will be notified of any action taken as soon as possible. *
Required
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