VBS 2022 Children's Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Aliso Creek Church | June 27th - July 1st | 9am-11:30am | 2A Liberty Aliso Viejo

Price: Free! Just bring 1 canned food item per child each day. These items will be donated to FAM (Family Assistance Ministries) at the end of the week.

Please complete this form by Friday, June 17th.

If you have any questions, please contact Jackie Sholar at:
jackie@alisocreekchurch.org | 949.573.1568

Parent Name *

Email Address *

Phone Number *

Address *

Home Church

Emergency Contact (Name, Relationship, Phone #) *

Family Physician (Name and Phone #) *

Child #1 (Name, Age/Grade Completed, Allergies/Special Needs) *

Child #2 (Name, Age/Grade Completed, Allergies/Special Needs)

Child #3 (Name, Age/Grade Completed, Allergies/Special Needs)

Child #4 (Name, Age/Grade Completed, Allergies/Special Needs)

Child #5 (Name, Age/Grade Completed, Allergies/Special Needs)

I give permission to include my child(ren) in VBS keepsake photographs and videos. *

Yes

I give permission for VBS staff to apply sunscreen to my child(ren) when engaging in outdoor activities. *

Yes

I release Aliso Creek Church, its agents and employees from any liability while my child(ren) attend this VBS. *

Yes

In the event that the parent/guardian or designated physician cannot be reached, I authorize the VBS staff to use his/her discretion to provide basic medical aid and/or secure emergency services, including paramedics, and accept the expense of these services. *

Yes

By electronically signing below, I confirm that all of the above information is accurate. Upon dropping off my child(ren) on the first day, I will physically sign the waiver form. *

VOLUNTEERS NEEDED!

Adult and youth volunteers welcome. If you're interested, contact Jackie Sholar at: jackie@alisocreekchurch.org | 949.573.1568

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms