Camp Firelight Vacation Bible School @ First Presbyterian Church of Rockaway (June 24th - June 28th, 2024)
Registration Form
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Email *
Child's Name *
Nickname/Preferred Name
Parent/Guardian Name *
Address *
Telephone Number(s) *
Child's Age *
Child's Date of Birth *
Gender *
School Grade Entering *
Home Faith Community (if any)
Emergency Contact (if parent/guardian cannot be reached)
Name, Telephone, Relationship to Child
Allergies/Medical Needs (if none please put NONE) *
Person(s) authorized for picking up this child at the end of the day: Name(s) and Telephone Number(s) *
Anything special we need to know about your child?
Shirt Size (indicate child/adult) *
One friend my child would like to be with:
Special Needs classification & or circumstances
We will be taking pictures during the week. We need your permission to take pictures of your child, put them on our PowerPoint Presentation for the final day, and our church website. *
Signature (type) *
Payment (Due at Registration) 
$25 per child or $60 per family
A copy of your responses will be emailed to the address you provided.
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