2018 Wintersburg VBS Registration
Welcome to Shipwrecked, the VBS where kids learn that Jesus rescues! This VBS adventure will help kids begin or deepen their faith by discovering that Jesus cares about them personally and rescues in life’s toughest circumstances

Classes are available for students age 3 through entering 5th graders — as well as adults! All preschoolers must be potty trained. For the 3 year old class, children must be 3 years old by the first day of VBS.

DATE: Monday through Friday, July 23-27, 2018
TIME: 9:00 am to 12:15 pm
PLACE: Wintersburg Presbyterian Church
2000 N. Fairview Street in Santa Ana

Also plan on bringing the entire family to a special program on Friday evening at 7:00pm. The children will prepare for it all week, so come and enjoy the show.

REGISTRATION DEADLINE: Friday, July 1, 2018
- Registration fee is $40 per attendee (child or adult). Maximum fee is $100 per family.
- Special early registration fee is $30 per attendee if registration and payment is received by May 1, 2018.
- There are class size limits this year.
- Registration confirmation will be sent by e-mail.

Three (3) Step Registration Process:
1) Register online (find the link) at: http://wpcsportsministry.org/events/winterburg-church/ or
http://www.wintersburg.org/childrens.htm
2) Use the “Buy Now” link on either site and pay with Paypal, a Credit Card or a Debit Card
3) Fill out page 2 of the “Shipwrecked" VBS Registration Form and email to wpcchildrensministry@gmail.com.

CANCELLATION POLICY: Full refund if requested by noon on July 1, 2018.

For more info regarding VBS, contact Sue Masamitsu at smasamitsu@wintersburg.org (714) 740-9400 x106 or Shirley Wong shirleyteacher@hotmail.com (714) 894-1561. We look forward to having you attend all week long.

Moms & Grandmas Can Join the Adventure Too!
Renew yourself with an enriching Bible study, fellowship, crafts, food and fun! A nominal fee to cover craft supplies will be collected. Childcare for children under 3 years old is available for Moms attending the adult class. Moms may be asked to help during the week.

ADULT VOLUNTEERS: Please indicate on the Shipwrecked Form the area(s) of interest that you would like to help out. We need volunteers for: Nursery, Kitchen & Snacks, Recreation, Decorating, Playground Duty, Lunch Crew, or Wherever Needed.

YOUTH VOLUNTEERS: Please fill out a Youth Volunteer Application.

NOTE CONCERNING PHOTOGRAPHY During the VBS program at WPC, photographing and/or videotaping of attendees may occur for use in crafts, class pictures, video/slideshow, displays, WPC website and newsletters. Please submit a written request if you do not want your child(ren) photographed or videotaped at VBS.

Join in the fun and wear the color for each day of VBS!
Monday-Blue, Tuesday-Purple, Wednesday-Yellow, Thursday-Green, Friday-Red

Email address *
Untitled Title
Parent information *
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Address *
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City *
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Zipcode *
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Home phone #
(###) ###-####
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Cell phone # *
(###) ###-####
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Email address *
Please note: Registration confirmation and important VBS information will be sent by email
Your answer
Church Affiliation *
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If Church Affiliation is "Other" please indicate the name of your church
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How did you hear about VBS? *
If you heard about our VBS program through family or friends, please indicate the name of the person
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Contact Person during VBS *
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Phone number of Contact Person *
(###) ###-####
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Emergency Contact Name *
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Relationship of Emergency Contact *
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Phone number of Emergency Contact *
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Name of Doctor *
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Doctor's Phone Number *
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Health Plan *
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Health Plan Member # *
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VBS Student1 Name
Your answer
VBS Student1 Gender *
Please select one
VBS Student1 Birthdate
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VBS Student1 - Grade entering in Fall 2018 or age 3 or 4 years
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VBS Student1 - Allergies or special needs
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VBS Student1 - First time at Wintersburg's VBS?
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VBS Student2 Name
(Last name, first name)
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VBS Student2 Gender
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VBS Student2 Birthdate
(mm/dd/yyyy)
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VBS Student2 - Grade entering in Fall 2018 or age 3 or 4 years
Please select one
VBS Student2 - Allergies or special needs
Your answer
VBS Student2 - First time at Wintersburg's VBS?
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VBS Student3 Name
(Last name, first name)
Your answer
VBS Student3 Gender
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VBS Student3 Birthdate
(mm/dd/yyyy)
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VBS Student3 - Grade entering in Fall 2018 or age 3 or 4 years
Please select one
VBS Student3 - Allergies or special needs
Your answer
VBS Student3 - First time at Wintersburg's VBS?
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VBS Student4 Name
(Last name, first name)
Your answer
VBS Student4 Gender
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VBS Student4 Birthdate
(mm/dd/yyyy)
Your answer
VBS Student4 - Grade entering in Fall 2018 or age 3 or 4 years
Please select one
VBS Student4 - Allergies or special needs
Your answer
VBS Student4 - First time at Wintersburg's VBS?
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Adult Class Participant Name
(Last name, first name) * Childcare for children under 3 is available if you are enrolled in the Adult Class
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Adult Class Participant - First time at Wintersburg's VBS?
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Child1 Name
(Last name, first name)
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Child1 Gender
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Child1 Birthdate
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Child1 - Allergies or special needs
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Child2 Name
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Child2 Gender
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Child2 Birthdate
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Child3 Name
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Child3 Birthdate
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Child3 - Allergies or special needs
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Child4 Name
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Child4 Gender
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Child4 Birthdate
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Child4 - Allergies or special needs
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