YeeHaw! MyChurch 2019 VBS Registration
Dates: June 3th-6th, 2019, 6:30 - 8 pm each night
Location: Sahuarita Lake Park, 15466 S. Rancho Sahuarita Blvd, Sahuarita, AZ 85629
Student Name (First)
Student Name (Last)
Date of Birth
Grade Entering in Fall 2019
(NOTE: If child is 3 years old, a parent or guardian must stay with the child)
Preschool - 3 years old (*guardian must stay with child)
Preschool - 4 years old
This is the first person we will contact in case of emergency
Primary Parent/Guardian Name
Primary Guardian Contact Phone Number During VBS
Secondary Emergency Contact
This is the second person we will contact if the primary contact is not able to be reached.
Secondary Emergency Contact Name
Secondary Emergency Contact Phone Number
Do you have a friend you would like to be placed with? If so, who?
Allergies/Special Needs/Additional Notes
PARENTAL RELEASE AND WAIVER AGREEMENT
By completing and submitting this form: I consent for my child to participate in the activities of MyChurch and voluntarily and absolutely release MyChurch from all liability for personal injury and/or damage as a result of engaging in any activities of MyChurch. I authorize and give full consent to MyChurch to use on their website all photographs in which I/my child appear while involved in ministries of MyChurch.
Send me a copy of my responses.
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