Vacation Bible School 2019

Name: Vacation Bible School 2019
Start: 2019-06-12T17:45:00-05:00
End: 2019-06-12T19:45:00-05:00
Location: Redeemer Church

Child's Name*

First Last

Upcoming Grade*

Child's Age*

Untitled

Child's Birthdate*

Gender*

Male
Female

Do you have additional children to register?*

Yes
No

Any allergies?*

Yes
No

List

Child's Name*

First Last

Upcoming Grade

Child's Age

Child's Birthdate

Gender

Male
Female

List

Child's Name

First Last

Upcoming Grade

Child's Age

Child's Birthdate

Gender

Male
Female

Child's Name

First Last

Upcoming Grade

Child's Age

Child's Birthdate

Gender

Male
Female

Parent / Guardian's Name*

First Last

Email*

Phone*

Emergency Contact Name & Phone Number*

Media Consent

I hereby consent to the use of photographs/video footage of my children for publicity purpose.

Medical Release*

In case of a medical emergency, I hereby give my permission to the physician selected by the Vacation Bible School director to secure proper treatment and/or hospitalization for my children

Signature of Parent / Guardian*

By typing your name below you are digitally signing and indicating agreement with the releases above. You understand that digitally signing this agreement has the same effect as physically signing a paper original.

Events

June 12, 2019 @ 5:45 pm - 7:45 pm

VBS Registration

Details

Redeemer Church Jackson

For Members

For Visitors