Ages 4-9 Elementary Ages 10-12 Middle School June 16-20 (Sun.-Thurs.) 4:30-7:30 PM Games, Crafts, Bible Stories, Music and Dinner $30.00 per child, $75.00 per family maximum Make checks payable to Trinity Presbyterian Church VBS 2013 Registration, 640 Berwyn Avenue, Berwyn, Pa 19312. Registration deadline: June 6. Questions: Call Yolanda: 610 644-0932 2013 Trinity Presbyterian SonSet Rainforest VBS Registration
Address___________________________________________ Parents/Guardians________________________ Email__________________________ Cell#________________ Home#______________ Work#___________ Age: Child 1________ Child 2_________Child 3_______ Child 4_______ Grade Completed: Child1____ Child2 ____ Child 3____ Child 4____ Home Church if any _________________________ 2 Emergency Contacts: Name______________ Phone _______________ Name________________ Phone_________________ ____ Yes, in an emergency, I give Trinity Presbyterian Church Permission to take my child (ren) to a hospital to be treated Insurance__________________ Policy#________________________ Physician___________________ Phone #___________________ List any Allergies, medical conditions, or special needs _______________________________________________________ List names of people that can pick up your child (ren)
I want to volunteer: __ Dinner prep __ Table Parent __ After Dinner clean up
___ Yes, I grant permissions for photos or videos to be taken of my child (ren) for Church Bulletin, website, and VBS overhead. ___ I do not grant permission for pictures or videos to be taken of my child (ren)
Signature for this application and permission for your child (ren) to attend VBS Parent/Guardian______________________________