Vacation Bible School Participant Registration
HIGH SEAS EXPEDITION

EXPLORE THE MIGHTY WORD OF GOD
JULY 25TH-29TH 9:00AM-12:00 PM
$10.00 per child $25.00 per family of three or more
Financial assistance available if needed)
Name____________________________________________________________________________________________________________
Address_________________________________________________________________________________________________________
Phone #___________________________________Cell__________________________________________________ Age____________
Food Allergies Y ( ) N ( ) Medical concerns Y ( ) N ( ) Explain_________________________________________________________________________________________________________
EMERGENCY CONTACT: Name_________________________________________________________________________________________
Phone________________________________________________Cell_______________________________________________________
People who may pick up your child:
1)______________________________________________________________________________________________________________
2)______________________________________________________________________________________________________________
3)______________________________________________________________________________________________________________
Parent Signature________________________________________________________________________________________________
TO AVOID DELAYS AND CONFUSION THE DAY OF, PLEASE INCLUDE REGISTRATION FEE WITH REGISTRATION FORM.
REGISTRATION DROP BOXES CAN BE FOUND IN CHURCH OFFICE, FELLOWSHIP HALL, AND NARTHEX. THANK YOU
For questions or information, contact Gloria Pease, Director 229-1513 or gloriadianne2945@yahoo.com
Put VBS 2011 in subject line