Double Dare Your Faith VBS 2018 August 2nd-5th 6-8pm

Parent/Gaurdian Name

You understand that you CANNOT and should not register any children that you are not legally responsible for?

Yes

This address will receive a confirmation email

Phone

Address

Emergency Contact Name

Emergency Contact Phone # 1

Emergency Contact phone #2

Allergies and other Medical Conditions:

Child #1 Name,

Grade entering for 2018-19 School year

Kindergarten 1st grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Child # 2 Name

Grade to be Entering 2018-19 Kindergarten 1st 2nd 3rd 4th 5th 6th

Child #3 Name

Grade to be Entering 2018-2019 School Year Kindergarten 1st 2nd 3rd 4th 5th 6th

I understand that Mt Zion Church will not be providing transportation. I understand I am responsible for dropping of my child no earlier than 5:45 pm and picking up my child no later than 8:35 pm.

YES

I give permission for my child to be photographed. Photos will be used for promotional purposes and may appear on church website, church newsletter, and Facebook page etc.

YES No

You understand that your child's experience at Mt Zion is going to be Life changing Fun, However it will take us getting a little messy to make this happen. Therefore we urge you not to send your children in atire of great importantace. Everything that will be used during VBS is label to be Non toxic and washable. So safety #1 to us and keeping stains out of clothes came up last on the list. :) Consider yourself Warned. (any child who chooses not to particapate in messy activites will not be made to do so. The choice will be their own the days of events.)

Yes

Is there anything we need to know not already included on this form:

Electronic Signature: All of the stated information is accurate to the best of my knowledge. I understand that typing my name in the box below represents my electronic signature and consent to all terms and conditions.

Electronic Signature

Today's Date

Double Dare Your Faith VBS 2018 August 2nd-5th 6-8pm

Description

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