Vacation Bible School Registration June 25-29, 2018
***Please note: We are excited to hold our VBS each EVENING from 6:00 PM-8:15 PM on the above dates!

On-Line Registration closes on Monday, June 18th!

Join us on Sunday, July 1 at 10:00 am for the Closing program and picnic!

Child's First Name *
Your answer
Child's Last Name *
Your answer
Grade Entering in Fall 2018 *
Date of Birth *
Your answer
Parent/Guardian Name *
Your answer
Home Address *
Your answer
Home Phone *
If none, write "N/A"
Your answer
Cell Phone *
Your answer
Work Phone *
If None, write "N/A"
Your answer
Email Address *
Your answer
Dismissal: Who may pick up your child at the end of each day? *
We will only release your child to names listed here.
Your answer
Do you have a home church? If so, where? *
Your answer
Check if you are a CKH Family.
May we photograph your child for the closing video highlight and also promotional purposes? (Children's names will not be used.) *
What allergies does your child have? *
Your answer
Does your child have any activity restrictions? *
If so, list what restrictions.
Your answer
If there is an emergency, and a parent or guardian cannot be reached, who may we contact? *
Give name and phone number
Your answer
Liability Release: As the parent or legal guardian of the child I am registering, I authorize the leadership of Wollaston Church of the Nazarene to care for the administration of the first aid treatment for any minor injuries my child receives during the event. If the injury sustained is life threatening, or needs emergency treatment, I authorize said leadership to summon any emergency personnel to attend, transport, and treat my child. I agree to hold any staff, assistants, and volunteer workers harmless from all claims, suits, costs, and actions of any kind whatsoever, arising from their exercise of power granted by this authorization. *
Please type your name in the box to indicate your agreement to the liability release.
Your answer
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