VBS 2017 Region 1 and Region 2 - Accommodation Form
Malankara Archdiocese of the Syrian Orthodox Church in North America
VBS Accommodation Form

This form is for parents, volunteers and chaperones to complete.

Dear Parent,
Please fill the form below to consent that your child is eligible to participate in VBS at the Mor Aphrem Center in Paramus NJ. The activity will take place under the supervision of teachers and volunteers.

Name of the event: Region 1 and Region 2 VBS of the Malankara Archdiocese
VBS Theme: Hero Central - Discover your strength in God
Bible Verse: “Do good, seek peace and go after it.” Psalm 34:14
Dates: Friday, Aug 25 5:30 pm to Saturday, August 26 5:00 pm
Location: Mor Aphrem Center at 55 West Midland Ave, Paramus, NJ 07652

Note: There are 8 rooms available with 4 beds in each room. Accommodations are meant for those that live far from Paramus. First come - First serve.

To view the location and accommodations - view link http://syrianorthodoxchurch.org/about/mor-aphrem-center/

Last Day to submit this form: Sunday, Aug 20, 2017 at 11:59 pm ET

1. Sheets
2. Pillows
3. Towels
4. Personal Hygiene items (Soap, Shampoo etc)
5. Sleeping Bags (if there are no beds, there is space for sleeping bags)

1. All participants must be on time for the all events and must abide by the rules.
2. No boys or girls will be in each other's rooms.
3. No drugs or alcohol will be allowed on site.
4. All participants must be respectful to the hosting facility and its staff members.

If any of the rules are not adhered to, the convening authority will contact the child's parents to return home with no refund.

Questions, please contact your Sunday School Headmaster or Mrs. Susan John (susanjohn827@gmail.com) or Mrs. Shija Geevarghese Ammayi (shijaalias@gmail.com).

Email address *
First Name *
Your answer
Last Name *
Your answer
Age *
Gender *
Parish Name and Location *
Your answer
If serving as a volunteer, what can you assist with?
Child's email address (if he/she has one)
Your answer
Child's cell phone (if he/she has one)
Your answer
Parent's Full Name (Father) *
Your answer
Parent's Full Name (Mother) *
Your answer
Parent's Cell Phone Number *
Emergency contact number
Your answer
Parent's Home Phone Number *
Your answer
Please list if your child has any allergies or medication (otherwise type none) *
Your answer
I understand that I will have to pay $$ upon arrival *
Waiver, I, as attendee/participant, acknowledge and accept the resposnibilty of the safety, liabilty and medical insurance for myself in case of any emergency and will not hold the coordinators, volunteers, or participants responsible. In case of emergency, I give permission for emergency medical treatment. I take full responsibility to abide by the rules and regulations. I agree to follow the rules and regulations and am aware that any failure to do so, may result in my dismissal from the site. I am aware that it is my responsibility to attend the sessions as scheduled and to maintain the Christian atmosphere. *
I herby consent to the participation of my child *
Parent: Please provide your name and initials that you have provided your consent. *
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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