Vacation Bible School Registration

Adventure in Galilee

Child’s Name/Nickname ______________________________________

Parent’s Name(s) ____________________________________________

Phone Phone _____________________

(9 a.m. to 2 .m.) (evening)

Street Address ZIP __________

Email Address _______________________________________________

Emergency Contact: Name______________________________________

Phone Number(s)__________________Relation to child______________

Information about my child Entering Grade _____ Birthday ________

Allergies/special needs

Please discuss any special needs or abilities your child has with your Christian Education Director. We want all children to feel God’s love this week. The VBS staff will be better able to share that love with children if they understand their needs and strengths.

I will attend the closing ceremony on Friday, August 3 at 11:30 a.m.

I would like to help before (_____) or during (_____) VBS. Please call me

Photographs of my child may be taken. No photographs from VBS will be used for profit. Children will be identified only by first names in print or the parish web sites.

Signature_______________________________ Date_____________________

If my child is ill or injured, the staff of VBS will attempt to contact me at the above phone numbers. I authorize treatment by emergency medical personnel.

Signature_______________________________ Date_____________________

Co-Sponsored by: St. Andrew’s , St. Mark’s, St. Matthew’s,

& Calvary Episcopal Churches

For more information, contact: Martha Holland (502/452-9581) , Debbi Rodahaffer(502/895-3485), Marti Taber(502/895-2429), or Callie Hausman (502/587-6011)