Vacation Bible School Registration 2017
August 7-10, 6-8:30 p.m. Children will enjoy the opportunity to learn about Jesus and the New Testament thru story, activities, crafts, food and song.

GOOD SHEPHERD CHURCH OF HILLTOWN
1634 Hilltown Pike
Hilltown, Pa 18927
215-822-3930
goodshepherdhilltown.org

For more information please contact Darya Tasker 215-833-3475

Parents/Guardians Names
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Email
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Address
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Home Phone Cell Phone
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CHILDREN TO BE ENROLLED
Name Age Grade Complete T shirt Size
(Please Indicate Shirt size with a C for Child and A for Adult, S, M, L)
1.
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2.
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3.
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4.
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EMERGENCY CONTACT INFORMATION
(Will be contacted after attempt to contact Parents)
Name Phone #
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Name Phone #
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ALLERGIES OR OTHER MEDICAL CONCERNS
I attest that my child is in good physical condition. Should any accident or illness occur during any VBS activity, I will not hold Good Shepherd Church or its VBS volunteers responsible for medical aid rendered and will reimburse them for the medical and other expenses incurred. The above named child/children may receive necessary first aid. He/she may receive medical attention by any duly licensed physician, and may be admitted into a hospital in case of emergency.
Vacation Bible School (VBS) leaders have permission to photograph/film the minor(s)designated above for any lawful purpose associated with this VBS program.
"PAY IT FORWARD PROJECT"
Please bring loose change and or donation for "Pay it forward Project" activity. The children will receive the money back for the project.
Parent Signature Date
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