VBS 2014 Registration

Grab your gear and bring a friend to SonRock Kids' Camp!

Campsite:

Calvary Bible Church

Camp Dates:

June 16th - 20th

Camp Hours:

9:00 a.m. - 12:00 p.m.

Camper Ages:

4 years - 6th grade (completed)

(as of 12/31/13)

* Indicates required field

Child's Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Grade Completed *

Birth month *

Birth year *

Allergies *

None Allergies listed below

Allergies *

Parents'/Guardians' Name *

First

Last

Parent's/Guardian's Email *

Emergency Contact *

First

Last

Emergency Contact's Phone *

Persons with my permission to pick-up my child (include phone #) *

By checking this box, I agree to the Medical Release terms: *

Medical Release: I, the parent/guardian of the above listed child grant permission for my child to participate in Vacation Bible School at Calvary Bible Church and to receive medical treatment if necessary. If I or the listed child care provider or emergency contact cannot be reached, I give my permission to the staff to secure the services of a licensed physician to provide necessary care, including anesthesia, for my child’s well-being. I also release and agree to hold harmless Calvary Bible Church and all its participants from any liability and assume all risk of injury, damage or expenses as the result of participation in activities in Vacation Bible School.

Submit