Vacation Bible School Registration

Vacation Bible School  August 2nd - 6th 8:30am-12pm

2010 Registration

Please fill out one form for each child.

 Child's Name:

Age: Birth Date: Grade Completed:

Please Check Camp Choice:

Monday - Friday K-5th Grade Camp  

Wednesday, Thursday, Friday Preschool Camp   

Name(s) of Siblings attending VBS:

Address:

City/Zip Code:

Parents/Guardians Name:

Phone Number:  Cell Number:

Extra Phone Number:

Email Address:

Name Child prefers to be called:

Church Home:

Allergy/Health/Special Information:

Name(s) of person(s) picking up child from VBS if other than parents/guardians:

NOTE: We will ask to see a picture ID of ALL people picking up a child (including parents/guardians).

Emergency Contact Information:

We will first attempt to contact a parent/guardian. In the event the numbers above do not put us in contact with a parent/guardian we will call the Emergency Contact. Please do not list a parent/guardian or phone numbers from above.

Name:

Phone Number(s):

Relation to Child:

My Child has my permission to attend and participate in the God's All-Star Champions VBS program.

        YES           NO

Parent/Guardian Signature:

Christ Church may take and publish pictures of my child. Pictures will be used for a slide show on August 9th and be posted on our web page. We will not publish names along with said pictures.

        YES           NO

Parent/Guardian Signature:

Questions regarding our photo policy, contact Leigh Ann Gigliotti, Director of Children's Ministry at 814-833-6398 or follow click here  to visit Christ Churches Children's Ministry Photo Galore page and click on Photo Policy.