Vacation Bible School

Signup Form

Dates: June 2-June 6th from 6pm-9pm

Theme: Breaker Rock Beach “Rock Solid Truth” Romans 12:2

Fill out as much of this form as you can. We will contact you if there are any issues.

Child's Name

Parent/Guardian Name

Street Address

City

State

Zipcode

Mailing Address If you receive your mail at a different address, please enter it here

Email address We'll never share your email with anyone else.

Home Phone Number

Work Phone Number

Cell Phone Number

Birth Date

Last Grade Completed

Medical Information

Medical or other Information we need to know. (Please include food allergies)

Emergency Contacts

Name and Phone Number

Dismissal Information

Who may pickup your child?

Other Information

If your child attends Sunday School, where do they attend? If your child is visiting our church, who are they a guest of?

Photography Permissions

We may take photos during the event.

I agree to allow my child to be photographed

I agree to allow the photos taken to be used for the purpose of promotion