VBS Pre-Registraion Form

 

2018 VBS

"Shipwrecked - Rescued By Jesus"

Date: Aug. 6th - Aug. 10th

Time: 6:30 PM - 8:45 PM

 

 

Child's' Name: 

 

Childs Age:   Childs Grade in Fall 2018:

 

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:

© 2013 - 2018 Church Of The Nazarene, Winnsboro, SC - All Rights Reserved.