Media Presbyterian Church - VBS 2025
We can't wait to see you the week of Aug. 4th-8th from 6:00-8:00pm at Media Presbyterian Church.  Please reach out to Jeanne Cunningham (fuselloj@gmail.com) or Ty Harvey (ty@mediapresbyterian.org) with any questions or concerns.  
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Child's name: *
Nickname/Preferred name:
Child's date of birth: *
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Grade for 25-26'  School year *
Parent/Guardian name(s):
Home address - please include zip code *
Phone number (best for reaching during VBS hours): *
Parent/Guardian email: *
Church affiliation: 
May we send you to the MPC Cornerstone Kids weekly email if you are not already on the list?
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Allergies that may impact their time at VBS: *
Medical concerns that may impact their time at VBS: *
Behavioral traits that may impact their time at VBS (may include fears, separation anxiety, etc.): *
Emergency contact (name and phone number) - Different from parent/guardian
Permission for photos of your child.  Please indicate if you consent or decline to photos taken of your child.  Photos of the kids engaged in the activities each night are shared to a slideshow for the kids to view while waiting for the closing program.  This year, MPC will not be streaming VBS on their YouTube channel.  *
In case of an emergency, I give permission to have my child receive first aid and be transported to the nearest hospital by professional emergency personnel. *
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Any thing else we need to know to help your child have a great week?
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