2020 VBS Pre-Registration Form

 

2020 VBS

"WILDERNESS ESCAPE: Where God Guides & Provides"  

Date: June 7th - 10th 

Time: 6:30 PM - 8:45 PM

For Ages: 3 years to 6th Grade

 

 

Child's' Name: 

 

Childs Age:   Childs Grade in Fall 2020:

 

Parents Names: 

 

Address: 

 

City:  Zip:  E-mail:

 

Phone:  Work:  Cell:

 

Emergency Contact Person:

 

Emergency Contacts Phone:   Emergency Contacts Cell:

 

Church membership at:

 

Please list any medical/health conditions or allergies that we should be aware of:



Video/Photo & Activities Release: I hereby grant the VBS leaders permission to photograph/film the minor(s) designated above in any manner or form for any lawful purpose associated with this VBS program. I also grant permission for my child to participate in the fitness activities each night.

Signature of Parent or Guardian:  Date:

Fill Out Form And Print To Turn In:

Fill Out Form & Submit To VBS Director:

     

If you have any questions please e-mail Rev. Ellen Broome:

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