Registration Form for VBS 2015
Transcription
Registration Form for VBS 2015
Child’s Name: _____________________________________ Age: _______ Next school grade in Fall ‘15: ____ Email: __________________________ Address: ______________________________________________________ City: ____________________________ State: _______ Zip: ____________ Phone: ________________________________ Birth Date: _____________ Shirt size (youth sizes): _______ Brought by: _________________________ Parent’s Name(s): ______________________________________________ y ter b er s i g Re ord 1 in eiving e n c Ju re re irt! u s n to e VBS sh a When: July 6-9, 9am-12noon Where: Redeemer Lutheran Church Who: Children ages preschool 3 (must be 3 by July 1, 2015 and potty trained) through entering 6th grade in the Fall 2015 Cost: $10 (helps offset shirt & supply costs) Howdy Campers! It’s time for Vacation Bible School (VBS)! At VBS, we’ll gather at Camp Discovery to learn about Jesus and how He works through us a super-BIG plan. Shout it from home to camp, as we trek out for an amazing week! Don’t miss the WILD GAMES, COOL SONGS, FUN SKITS, and SUPER SNACKS. Question? Want to sign up? Volunteer? Contact the church office (573-364-7071) or visit RedeemerRolla.org. We hope to see you there! Redeemer Lutheran Church 1701 Hwy 72 E, Rolla, MO 65401 573-364-7071 info@RedeemerRolla.org Home Church: _____________________________ City: ______________ Emergency Contact Name: ____________________________________ Phone: ______________________ Relationship to child: ______________ Medical or other allergies we should be aware of: _________________ ______________________________________________________________ ______________________________________________________________ I, the parent/guardian of this registered child hereby give permission for him/her to participate in Vacation Bible School at Redeemer Lutheran Church (Rolla, MO). I consent to his/her participation in the activities planned for this event and certify that he/ she is physically able to engage in the event. I hereby grant to the leader in charge of the group the right to make emergency medical decisions for my child in the event I cannot be reached. I understand I/we release and forever discharge Redeemer Lutheran Church, its staff and adult chaperones from any and all claims, demands, actions, or causes of action, past, present or future arising out of any damage or injury while participating in this event. I am at least 18 years of age, I understand the above statement and am competent to execute this agreement. Please check “no” if you do not wish for Redeemer Lutheran Church (Rolla, MO) to use for publishing or showing minor child’s still or moving image. Parent/Guardian Signature: _____________________________________ Print Name: ______________________________ Date: _______________ In-House Information: Cash | Check (#_______) Registration Emerg. Info Shirt