VBS Registration Form — Lancaster First Assembly of God

SONROCK KIDS CAMP VBS

Where kids build theIr lives on the rock, Jesus!

July 9 - 13, 2018

9:30 am - noon each day

Use the form below to register. A separate registration form must be received for each child. Fill out the information below. A Bus ministry is available for those who have no other way of getting to the VBS.

PARENT/GUARDIAN INFORMATION

Please enter all of the requested information below

Name

First Name

Last Name

Email Address

Phone 1

Best Conctact

(###)

###

####

Phone 2

Secondary Emergency Contact

(###)

###

####

CHILD INFOROMATION

Please enter all the requested information below

Child's Name

First Name

Last Name

Child's Age

Last Grade Completed

Allergies

Please list all known allergies. If none, please type "none" in the field.

TRANSPORTATION

First Assembly operates a Bus Ministry to enable as many children to participate as possible. Due to limited space, it is intended for those children who do not have another way of getting here. Please sign up for the Bus Ministry only if your child has no other means of transportation to the VBS. In order to be placed on the pickup list, the child's parent or guardian must first sign a permission slip. Please contact Mary@Lancasterfirst.com or call 717-397-1112 to request a permission slip.

Checkbox

Yes. My child needs a ride on the Bus Ministry in order to be able to attend Vacation Bible School.

Address

This information is required in order to be scheduled for pickup on the Bus Ministry

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

By typing my name in the filed below, I hereby give permission for my child to be picked up and travel on the bus or van to VBS and be returned home and dropped off on the bus or van after VBS. I assume responsibility for having my child ready for pickup at the agreed upon time and I assume responsibility for supervision of my child after he/she is dropped off following the event.

MEDICAL INFORAMATION

Please fill in all the requested information.

List any medication allergies

Is There anything in the child's medical history that medical personnel should be aware of in the case of an emergency?

By typing my name in the field below I hereby give my child permission to participate in the Lancaster First Assembly VBS being held from July 9-13, 2018. I assume full liability of hazard and risk for my child during VBS. In the event of a medical emergency, I give permission for hospital or medical staff to administer any necessary treatment immediately to my child should he'she be sick or injured during the VBS activities. I do not hold Lancaster First Assembly nor its respecctive officers and staff responsible for any injury that may result from my child's participation in VBS.

SONROCK KIDS CAMP VBS

Where kids build theIr lives on the rock, Jesus!

July 9 - 13, 2018

9:30 am - noon each day

CONTACT

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