Palma Ceia Presbyterian Church

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STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Hero Central

Palma Ceia Presbyterian’s VBS 2018
June 4-8
9 a.m.-12 p.m.

At "Hero Central" we will discover our strength received in God and explore how we can demonstrate characteristics of heart, courage, wisdom, hope, and power.

Vacation Bible School is open to kids who've completed Pre-K4-5th grade. A Pre-K3 (completed) class is available for full time VBS volunteers and the registration fee applies. Nursery care is available for full time volunteers at no cost. Registration for Pre-K3 and Nursery are unable to be processed online. Please print the registration form, complete and submit to the church office Attn: VBS.

Questions contact Susan LeBlanc susanelizabethleb@gmail.com or Mary Taggart marymactaggart@hotmail.com.

Qty

Description

Amount

Total

Child Registration(s)

$50.00

---

per child

Family Registration

$125.00

---

per family 3-4 children

Registration is not complete until your payment is sucessfully processed.

For all cancellation requests through May 20, 2018 there will be a $25 cancellation fee (per family) deducted from any approved refund. Cancellation and refund requests must be made in writing and a check will be mailed to the Parent or Guardian address provided after June 1st. Beginning May 21, 2018, registration fees are non-refundable but we would appreciate if you would notify Palma Ceia Presbyterian if your child will not be attending.

Total: $0.00

Child Information

Please enter all children who have completed Pre-K4 through 5th grade on one registration form. Click the green button “Show More Child(ren)" information to add additional children.

Child's Name #1: *

(first, last and preferred name)

Age: *

Date of Birth: *

Current Grade: *

School:

Gender: *

T-Shirt Size: *

Friend Request:

(maximum 2 - not guaranteed)

Known allergies/medical conditions:

Parent/Guardian Information

Parent/Guardian #1: *

Email: *

Parent/Guardian #2:

Email:

Parent Address: *

Address 2:

City: *

State: *

Zip Code: *

Phone Number: *

Questions/Comments:

Additional Information

Emergency Contact: *

Emergency Phone: *

Physician:

Preferred Hospital:

MEDICAL CONSENT & GENERAL RELEASE for Vacation Bible School

I /We do hereby release the staff and officers from liability of accident, illness or injury duing his/her participation in the Vacation Bible School activities at Palma Ceia Presbyterian Church June 4-8, 2018. I/We authorize the persons presenting this form to call a physician and to consent to any transportation, x-ray examination, anesthetic, medical or surgical diagnoses or treatment and hospital care which is deemed advisable for my/our child in case of emergency. It is understood that a conscientious effort must be made to notify me/us before such action is taken.

I have read this release statement, and I understand and voluntarily agree to its provisions.

VBS Permission to Photograph/Video

I give my permission for Palma Ceia Presbyterian Church to take photo/media images of my child and use the images in church created print or digital media.

Permission to Photograph/Video: *