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Vacation Bible School Student    Registration Form

VBS is open to children Age 4 - Rising 6th graders      ***Pre-registration ONLY for 2018***

July 16-20 | 9am - 12pm

Hope Presbyterian Church

11121 Leavells Rd, Fredericksburg, VA 22407

 

Parent / Guardian information
Parent Guardian Name: *
Parent Guardian Name:
Current Address *
Current Address
Phone (best to reach during VBS) *
Phone (best to reach during VBS)
Alternate Phone #
Alternate Phone #
Total children registered
First Child's Information
Child's Name
Child's Name
Birth Date
Birth Date
If your child has a food, topical, or environmental allergies please add here, with as many details as possible.
If your child requires special attention for any physical, mental or emotional needs, please indicate those needs here. It is very important to use that we provide a safe learning environment for your child and all the children who attend VBS. If your child needs a "buddy", we will "assign" one as we are able, and/or invite you to participate alongside them. We love all children at Hope!
Second Child's Information
Child's Name
Child's Name
Birth Date
Birth Date
If your child has food, topical, or environmental allergies please indicate that here, with as many details as possible.
If your child requires special attention for any physical, mental, or emotional needs, please indicate those needs here. It is very important to us that we provide a safe learning environment for your child and all the children who attend our VBS. If your child needs a "buddy" then we will assign one as needed, and/or invite you to participate alongside them. We love all children at Hope!
Third Child's Information
Child's Name
Child's Name
Birth Date
Birth Date
If your child has food, topical, or environmental allergies please indicate that here, with as many details as possible.
If your child requires attention for any physical mental or emotional needs, please indicate those needs here. It is very important to us that we provide a safe learning environment for our child and all the children who attend VBS. If your child needs a "buddy" we will assign one as needed and/or invite your to participate alongside them. We love all children at Hope!
ADDITIONAL INFORMATION
Parental Agreement
In case of emergency, I understand that every effort will be made to contact me.  If I can’t be reached, I hereby give the Children’s Ministry Leaders of HOPE Presbyterian Church permission to act on my behalf in seeking emergency treatment for my child in the event that such treatment is deemed necessary.  I give permission to those administering emergency treatment to do so, using those measures deemed necessary. *
Check to agree
Photography/Video Agreement
I give HOPE Presbyterian Church and its staff permission to take pictures and/or videos of my son/daughter for purposes of publicity and promotion on hopechurchva.org, social media outlets and any work or promotion produced by the Children’s Ministry and church. *
click checkbox to agree
HOPE T-shirt (for sale)
Hope T-shirts will be on sale for pre-order in late April/early May.
VBS Music CD's (for sale)
VBS Music CD's will be available for purchase during the week of VBS on a first come first serve basis.