BREAK OUT! VBS Participation Form
Who: kids ages 3 (must be potty trained) to entering 6th grade this coming fall. 
What: An exciting, fun-filled week at Vacation Bible school where kids will learn that God breaks us out of the ordinary to give us something extraordinary.
When: July 6-10, 6PM-8:30PM
Where: Movement Church- 3680 Manchester Rd. Akron, OH 44319
Cost: This event is absolutely FREE for kids to attend! We will be collecting donations of school supplies throughout the week for our annual Back to School Giveaway, blessing families in our community. 

THEME DAYS: (there will be a dress up theme everyday and prizes for the student participating the most in the theme for that day!) 
MONDAY: Backwards Monday (wear your clothes backwards) 
TUESDAY: Camo Tuesday (wear your best camo-try to blend in!) 
WEDNESDAY: Secret Agent Wednesday (dark clothing, fedoras, dark sunglasses, you get the idea)
THURSDAY: Double Agent Thursday (think business on top, pj's on bottom- like a 2020 zoom call) 
FRIDAY: Frazzled Friday (the messier hair- the better) 

Contact: Please feel free to contact Ashlynn at 330-780-3212 with any questions, comments or concerns
(If registering more than 4 kids, you will need to submit a second form.)
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