2019 VBS Registration
Time: June 25 - 28, 2019 6:00 p.m. to 8:00 p.m.
Address: 4537 Chatsworth St., Pittsburgh, PA 15207
Contact us at (412) 521-0994 or stjohnpgh@gmail.com
General Info
● A meal will be served each night.

● On the final night, parents are invited to attend our Closing Program where you can see what your child has learned about Jesus through songs, crafts and Bible-based lessons.

● Vacation Bible School is free. However, a free will offering will be taken each night.

Student Info
This form will allow you to register yourself and/or your child(ren), one student at a time. When you submit this form, you will be provided the opportunity to register additional students.
Student's Name *
Your answer
Age *
Gender *
Dietary restrictions *
Allergies//Medications
PLEASE LIST ANY ALLERGIES OR MEDICATIONS YOUR CHILD TAKES THAT YOU FEEL WE SHOULD BE AWARE OF.
Your answer
Parent/Guardian Info
Parent/Guardian Name *
Your answer
Phone number *
Your answer
Email (optional)
Your answer
Emergency Contact name (if different from parent/guardian)
Your answer
Emergency Contact phone number
Your answer
Volunteer
Will you/your child need transportation?
Street address
If you need transportation, please provide us with your full address.
Your answer
Release
By checking the "Agree" box below, I give my permission for my child(ren) to attend the VBS program at St. John The Evangelist Baptist Church and I agree to release the church and volunteers from any and all claims and liabilities arising out of their attendance and/or transportation to and from the church.
Medical Release *
Media Release *
*
Submit
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