(Participant) Jamesville Community Church Vacation Bible School

Participant Registration

Child's name:

Child's age:

Date of birth:

Last school grade completed:

Name of parent(s)/caregivers

Phone:

Alternative phone:

Email:

This address will receive a confirmation email

Address:

I hereby grant permission to Jamesville Community Church to take and use photographs and/or video taken throughout the week in publications, Facebook, online, and in other communications related to the mission of Jamesville Community Church. Names will not be included.

Yes No

Please list names of those approved to pick up your child:

Medical and Emergency Information

We take every precaution to ensure your child's safety. This information will be shared only with the Directors and leaders of VBS.

In the case of an incident or emergency - please fill out the secion below for us to contact you.

Allergies, medical conditions, or special needs:

In case of emergency, contact:

Phone:

Relationship to Child

Donations (optional)

VBS is free for everyone and is made possible in partnership by the charitable gifts of this community. Your donations of any size are greatly appreciated.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

July 15th to July 19th 9:00 A.M. - 12:00 P.M.

AGES: All children going into Pre-K to 6th grade this fall are invited to VBS! Youth and adults 7th grade and up are welcome to volunteer!

VBS CELEBRATION AND PICNIC: On Friday July, 19th we will hold a VBS celebration and picnic (weather permitting) at 11:15. Family and friends will have the opportunity to hear what the children have been learning and singing.

We look forward to VBS and having lots of fun along the way with Bible story telling, crafts, music, games and snacks!

If you have any questions or concerns, please do not hesitate to contact us. Thank you for your support!

DIVE ON IN!

Alex and Christina Snow
315-247-3733
alexanderdsnow@gmail.com
christinasnow159@gmail.com

(Participant) Jamesville Community Church Vacation Bible School

Description

Please Fix the Following