Elon Community Church UCC VBS Registration
Lead kids on an action-packed VBS adventure! Rolling River Rampage invites children on a white-water rafting adventure to experience the ride of a lifetime with God! Along the river, children discover that life with God is an adventure full of wonder and surprise, and that they can trust God to be with them through anything. Relevant music, exciting science, creative crafts, fun recreation, and memorable Bible stories will help kids know that God is always with them as they ride the rapids of amazing grace!

Sunday, June 17, 4-7 pm (Family Cookout)
Monday, June 18 - Wednesday, June 20
5:30 pm - 8:15 pm
Ages 3-12

Elon Community Church UCC
271 N. Williamson Avenue
Elon, NC

Student Information
Child #1 Name: *
Your answer
Child #1 Birthdate: *
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Child #1 Grade in School (2018-2019) *
Child #2 Name:
Your answer
Child #2 Birthdate:
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Child #2 Grade in School (2018-2019)
Child #3 Name:
Your answer
Child #3 Birthdate:
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Child #3 Grade in School (2018-2019)
Child #4 Name:
Your answer
Child #4 Birthdate:
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Child #4 Grade in School (2018-2019)
Parent/Guardian Contact Information
Primary Parent/Guardian Name: *
Your answer
Primary Parent/Guardian Phone Number: *
Your answer
Primary Parent/Guardian E-mail Address: *
Your answer
Secondary Parent/Guardian Name:
Your answer
Secondary Parent/Guardian Phone Number:
Your answer
Secondary Parent/Guardian E-mail:
Your answer
Home Mailing Address *
Your answer
Emergency Contact Information
Please list the name and phone number of the adult who should be contacted in case of an emergency during VBS hours.
Emergency Contact Name: *
Your answer
Emergency Contact Phone Number: *
Your answer
Event Related Questions
Dinner and Snacks will be served each night. Does your child have any dietary restrictions? *
If Yes, please list:
Your answer
The opening night is a family cookout. Please let us know the total number of people coming from your family: *
Your answer
Are you willing to serve as a VBS volunteer? *
If yes, please list your name and e-mail address below:
Your answer
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