Dare To Be Different -Vacation Bible School
Event Timing: August 27th-August 31st, 9AM-12:15PM
Event Address: 3427 Olney Laytonsville Rd, Olney, MD
Contact us at (123) 456-7890 or no_reply@example.com
Email address *
Child's Name *
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Child's Birthday *
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Child's grade completed *
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Child's Name (2)
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Child's (2) Birthday
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DD
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YYYY
Child's (2) grade completed
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Child's Name (3)
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Child's (3) Birthday
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DD
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YYYY
Child's (3) grade completed
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Child's Name (4)
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Child's (4) Birthday
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Child's (4) grade completed
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Parent(s) Names *
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Parent(s) Address
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Parent's Email *
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Parent(s) Cell numbers, please indicate the best number, and to which parent it belongs *
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Home Church
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Allergies, Medical Information or other concerns (If none, please write none) *
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Emergency Contact, name and number (if parents cannot be reached) *
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Emergency Contact, name and number (if parents cannot be reached) *
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List names of persons who may pick up child from VBS, name and relationship (If different than parent)
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List names of persons who may pick up child from VBS, name and relationship (If different than parent)
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PHOTO RELEASE FORM I hereby grant St. John's Episcopal Church permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications. *
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The Cost of VBS is $30 per child. You can make payment to St. John's Episcopal Church, via check or cash, either by mail or dropping it to the office during office hours. Please write VBS in the memo with the child's name.
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