Vacation Bible School
Central Valley Baptist Church
July 17-21, 2017
9:00AM - 12:00PM
600 N. Ten Mile Rd. Meridian, ID 83642
Contact us at (208) 888-4189 or office@centralvalleybaptist.com
Registration Information
Our VBS is for children age 3 through finished 6th grade. The 6th grade VBS will be off-site for a special time together. Childcare for ages 0-2 is provided for families working in VBS. We will be using a secure check-in system with child and parent receiving matching tags. Parents will need to show their tag to have a child released to them. Please complete the form below for each child you are registering. We would love to have your child registered as early as possible, but they can register at the door during VBS.
Child's First and Last Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child's Age or Last Grade Completed as of July 1, 2017
Allergies or medical conditions we need to be aware of
Your answer
Parent / Guardian Name(s)
Your answer
Parent / Guardian Phone(s)
Your answer
Address (please include city and zip)
Your answer
Email
Your answer
Church your family attends (if any)
Your answer
Person(s) authorized to pick up child (other than listed above)
Your answer
Emergency Contact
Your answer
Emergency Contact Phone
Your answer
Emergency Medical Release
By entering my name below and as a parent/guardian of the above child, I do hereby authorize treatment by a qualified and licensed medical doctor in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to contact me.
Name of Parent/Guardian
Your answer
Date
Your answer
Submit
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