Vacation Bible School

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Vacation Bible School Registration Form

Thank you for registering for Vacation Bible School. We appreciate your commitment to our ministry.

Children
Children 2 years through 6th grade will participate in MAPS: Mission Adventure Preparation School! Our children will learn about the adventure of sharing the Gospel to the ends of the world!

Youth
We also have exciting things planned for our youth (grades seventh through twelfth). They will explore the Missionary Journeys of Paul through a focus on the book of Acts.

Adults
And finally for the adults, we are pleased to announce that we have a guest speaker who will bless us each evening with messages focused on missions. In addition, we will be offering a Summer Seminar Series that will help our adults with life strategies (health, legal and employment). Childcare for the series will be provided for children less than 2 years of age.

Registration

Please indicate how many individuals you are registering by category (i.e. children, youth and adults).

Qty

Description

Amount

Total

Nursery

$5.00

---

(2 years and under)
The fee includes a light meal and the cost of other supplies and materials for VBS.

Child(ren)

$10.00

---

(2 years old to sixth grade during the 09/10 school year).
The fee includes the T-shirt, a light meal and the cost of other supplies and materials for VBS.

Youth

$10.00

---

(Grades seventh through twelfth).
The fee includes the T-shirt, a light meal and the cost of other supplies and materials for VBS.

Adults

$5.00

---

The fee will help to defray the cost associated with bringing in the guest speaker and for materials associated with VBS.

Donation Amount

Total: $0.00

Parent/Guardian/Donor Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Volunteer Information
Please indicate if you are willing to serve as a worker during VBS.

Children’s Vacation Bible School

Youth Vacation Bible School

Vacation Bible School Attendees

Please complete the following information for each person that you are registering for the Vacation Bible School.
Please Note:

Grades for children and youth should be for the Current school year.
All VBS T-shirts will be available the week of VBS.
Children should not be dropped off for Vacation Bible School. Adults should check their
children in and out each evening and then remain on site during the activities during the
week.

Child Name #1:

Age:

Grade:

T-Shirt Size:

Adult Emergency Contact

Name:

Phone:

Medical Treatment Consent/Liability Release

In case of an emergency, if in the judgment of any representative of VBS, one of the above children should require immediate medical care and treatment as a result of an injury or sickness, I do hereby request, authorize, and consent to such care and treatments be given to said child by physician, nurse, church representative or Hospital Emergency room. I understand and hereby release the leaders and volunteers from all claims, demands, actions, and causes of every nature. Further, I agree to assume sole responsibility for payment of any medical, dental, or other expenses incurred as a result of such sickness and/or injury and I will not hold VBS liable for any payment, fees, fines or further obligations that may be associated with such sickness and or injury.

The purpose of the above information is to ensure that Medical Personnel have details of any medical problem, which may interfere or alter treatment.

Release Agreement: *

I have read and understand the above statement and all the above information is true.

Test Payment Information (enter below)

Name on Card = test
Card Type = VISA
Card Number = 4222222222222 (4 followed by 12 twos)
CSC = 123
Exp Date = 10/20

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *