North Springs UMC Vacation Bible School 2022

VBS: MAKE WAVES

Join us for a week of great fun, starting July 25-28 from 6:00p.m.-8:30p.m.

We have Arts & Crafts, Games, Prizes, Bible Study, Music, Dance

and much more....

Dinner served nightly at 6:15 p.m. - 6:45 p.m.

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* 1. Adult/Parent/Guardian #1 Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Adult/Parent/Guardian #2 Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. Child's Information #1

Name

Date of Birth

Child's Age

Gender

Last Grade Completed

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* 4. Child #1: Facts concerning the child’s medical history including allergies, medications being taken and any physical impairments to which a VBS staff/physician should be alerted: (Please list: required)

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* 5. Child's Information #2

Name

Date of Birth

Child's Age

Gender

Last Grade Completed

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* 6. Child #2: Facts concerning the child’s medical history including allergies, medications being taken and any physical impairments to which a VBS staff/physician should be alerted: (Please list: required)

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* 7. Child's Information #3

Name

Date of Birth

Child's Age

Gender

Last Grade Completed

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* 8. Child #3: Facts concerning the child’s medical history including allergies, medications being taken and any physical impairments to which a VBS staff/physician should be alerted: (Please list: required)

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* 9. Emergency Contact

Emergency Contact Name

Phone Number

Relationship to Child

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* 10. EMERGENCY AUTHORIZATION FORM:
I understand all reasonable safety precautions will be taken at all times to protect my child during VBS. I understand the possibility of unforeseen hazards and the inherent possibility of injury. I understand that in the event medical intervention is needed for this child, an attempt will be made to immediately contact the persons listed on this form. In the event that I cannot be reached in an emergency, I hereby give my permission for NSUMC to call 911 and request emergency services and/or for a church representative to transport my child to a medical emergency or urgent care facility for treatment.
Please answer Yes or No:(required)

Yes

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* 11. MEDIA RELEASE AUTHORIZATION:
We, the undersigned parent(s) or guardian(s) do hereby grant permission to North Springs United Methodist Church to use the likeness of my child in any video, electronic (web) promotional or educational materials as they deem appropriate. Please answer Yes or No:(required)

Yes

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* 12. STAY CONNECTED
Please email me about future children's actvities throughout the year (i.e., Harvest Festival, Sunday School Kick Off, Angel Tree, Easter Egg Hunt)
Please answer Yes or No:(required)

Yes

North Springs UMC Vacation Bible School 2022

VBS: MAKE WAVES

Question Title

* 1. Adult/Parent/Guardian #1 Information

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* 2. Adult/Parent/Guardian #2 Information

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* 3. Child's Information #1

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* 4. Child #1: Facts concerning the child’s medical history including allergies, medications being taken and any physical impairments to which a VBS staff/physician should be alerted: (Please list: required)

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* 5. Child's Information #2

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* 6. Child #2: Facts concerning the child’s medical history including allergies, medications being taken and any physical impairments to which a VBS staff/physician should be alerted: (Please list: required)

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* 7. Child's Information #3

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* 8. Child #3: Facts concerning the child’s medical history including allergies, medications being taken and any physical impairments to which a VBS staff/physician should be alerted: (Please list: required)

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* 9. Emergency Contact

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* 12. STAY CONNECTEDPlease email me about future children's actvities throughout the year (i.e., Harvest Festival, Sunday School Kick Off, Angel Tree, Easter Egg Hunt)Please answer Yes or No:(required)

* 12. STAY CONNECTED
Please email me about future children's actvities throughout the year (i.e., Harvest Festival, Sunday School Kick Off, Angel Tree, Easter Egg Hunt)
Please answer Yes or No:(required)