2019 1/2 Day Bible Camp Registration
July 15th -19th
9:00am-11:30am
Dac Rowe Field, Waterbury
Optional Lunch 11:30-12:30 - Please RSVP Below.
End of Camp Celebration - Friday at 11:00am - All parents are inited to come hear what their children have learned all week!!
Child's Full Name
Please fill out a separate form for each child.
Your answer
Age
Your answer
Grade Completed (if applicable)
Your answer
I would like for my child to eat lunch after camp. (Pickup at 12:30pm)
If Yes, please list any specific food allergies.
Your answer
Parent/Guardian Name
Your answer
Cell Phone Number
Your answer
Parent/Guardian Name
Your answer
Cell Phone Number
Your answer
Address
Your answer
Email Address
Your answer
Do you have a church home?
If yes, which church?
Your answer
What person do we contact in case of an emergency if the parent/guardian is unavailable?
Name
Your answer
Relationship
Your answer
Phone Number
Your answer
What person has permission from the parent/guardian to pick up this child?
Name
Your answer
Relationship
Your answer
Phone Number
Your answer
Does your child have any specific medical needs we should know about?
If yes, please describe:
Your answer
Does your child have any allergies?
If yes, please describe:
Your answer
Does your child have any emotional or physical difficulty of which we should be aware?
If yes, please describe:
Your answer
I authorize the staff of VBS to take necessary emergency steps to protect my child in the event I cannot be reached.
Please note that this will need to be signed when you drop your child off at VBS.
Your answer
Name of person completing this form:
Your answer
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