VBS Registration Neelsville Church 2017

REGISTRATION IS NOW CLOSED. THANK YOU FOR YOUR INTEREST!

This year's theme is Maker Fun Factory and celebrates that we have been created by God and built for a purpose! Fun snacks, activities, games, and songs make this a week a special one for your child.

July 17-21 9am-12pm
Pick up on Friday, July 21 is 11:00 am for special program and lunch picnic for parents and children.
Pre-K through 5th grade

Materials Fee: $25 (includes T-shirt, one CD per family, and materials for the week)
Maximum materials fee capped at $60 per immediate family (siblings).
If the materials fee is a financial difficulty, please e-mail the director, Jamie at neelsvillekids@gmail.com

Registration is complete once payment and this form are submitted. You can mail a check to the church or drop it in the VBS Maker Factory Bin in the church welcome center on Sunday or during office hours. Or you may pay online using this link. http://neelsville.org/about-us/donate

Please submit one registration per child.

Child's First and Last Name
Your answer
Child's Birthdate
MM
/
DD
/
YYYY
Grade Child is entering in the fall
T-shirt size preference
Allergies
Please describe any medical or behavior concerns that would allow us to best serve your child. If there are no concerns, please state "none."
Your answer
Does your child have a friend or sibling your child would prefer to be placed with who is also attending VBS? List name.
Your answer
Please list first and last names all siblings also attending this VBS. If you have already filled out a form for another sibling, you may skip the rest of this form since you've already entered the information.
Your answer
Street Address
If you'd already filled this out for another sibling, you may skip this step.
Your answer
City
If you'd already filled this out for another sibling, you may skip this step.
Your answer
State
If you'd already filled this out for another sibling, you may skip this step.
Your answer
Zipcode
If you'd already filled this out for another sibling, you may skip this step.
Your answer
Parent/Guardian 1 First and Last Name
Please provide the name of the parent who will primarily be dropping off and picking up your child.If you'd already filled this out for another sibling, you may skip this step.
Your answer
Parent/Guardian 1 Phone Number
If you'd already filled this out for another sibling, you may skip this step.
Your answer
Parent/Guardian 1 E-mail
If you'd already filled this out for another sibling, you may skip this step.
Your answer
Parent/Guardian 2 First and Last Name
If you'd already filled this out for another sibling, you may skip this step.
Your answer
Parent/Guardian 2 Phone Number
If you'd already filled this out for another sibling, you may skip this step.
Your answer
Parent/Guardian 2 E-mail
If you'd already filled this out for another sibling, you may skip this step.
Your answer
If either parent/guardian cannot be reached in case of emergency, what is the name of another responsible adult who could be contacted?
If you'd already filled this out for another sibling, you may skip this step.
Your answer
Phone number for alternative responsible adult listed above.
If you'd already filled this out for another sibling, you may skip this step.
Your answer
How are you paying for the materials fee?
If you'd already filled this out for another sibling, you may skip this step.
In addition to the emergency contact already listed, please list the name of all persons who have permission to pick up all of your children attending .
If you'd already filled this out for another sibling, you may skip this step.
Your answer
Do you give permission to Neelsville Church to use photos of your children for website, social media, or other promotional uses?
If you'd already filled this out for another sibling, you may skip this step.
How did you hear about Neelsville's VBS
If you'd already filled this out for another sibling, you may skip this step.
Do you attend a church?
If you do attend a church, what is the name of your church? Example: Neelsville
Your answer
Are you available to serve as a volunteer during VBS and would like to be sent a volunteer application? Background checks are conducted for all volunteers.
If you'd already filled this out for another sibling, you may skip this step.
By signing and dating this form, I release Neelsville Church from liability and hold the church and its representatives harmless for the duration of Vacation Bible School. Your typed name counts as your signature for this online form.
First and last name and date
Your answer
Submit
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