2023 Holliston UMC VBS Registration

WHAT: Vacation Bible School

WHO: 3.5 yrs old (3 by 1/1/2023) - 6th grade (as of Fall 2023)

WHEN: June 21st (Wednesday) - June 24th (Saturday)

*June 21st (Wednesday) - June 23rd -- 5:30-9:00pm (Dinner will be served at 5:30pm)

*June 24th (Saturday) -- 10:00am-2:00pm (Lunch will be served)

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FEE:

* Early Registration WITH FULL PAYMENT (through June 11th): $30 for 1st child, $25 for each additional child
* Late Registration (after June 10th): $35 for 1st child, $30 for each additional
Registration includes t-shirt and materials

***T-shirts are NOT guaranteed after June 11th.***

Financial aid is available. Please email esther@ourcch.org or joyki2014@gmail.com

Payment can be made through

* PayPal (see below)

OR

* Check (payable to: Holliston UMC (in Memo, write"VBS" and child(ren)'s name(s)).

Checks can be given to P Ki or P Esther or mailed to:
Holliston Children's Ministry (VBS), 1305 E. Colorado Blvd., Pasadena, CA 91106).

Questions? Contact esther@ourcch.org or joyki2014@gmail.com

Child 1's Name*

First NameLast Name

Child 1's Birth Date*

Date

Child 1's Grade (in Fall 2023)*

FemaleMale

Child 1's T-shirt Size*

Child 2's Name

First NameLast Name

Child 2's Birth Date

Date

Child 2's Grade (in Fall 2023)

FemaleMale

Child 2's T-shirt Size

Child 3's Name

First NameLast Name

Child 3's Birth Date

Date

Child 3's Grade (in Fall 2023)

FemaleMale

Child 3's T-shirt Size

Child 4's Name

First NameLast Name

Child 4's Birth Date

Date

Child 4's Grade (in Fall 2023)

FemaleMale

Child 4's T-shirt Size

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information*

First NameLast Name

Parent/Guardian E-mail*

example@example.com

Parent/Guardian Cell Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact's Name (Other than parent listed above)*

First NameLast Name

Emergency Contact's Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Does your child(ren) have any allergies, chronic illness, or medical conditions? If none, write "none". If yes, please specify which child and describe. *

How did you hear about our VBS?

By intialialing below, we acknowledge and understand photos will be taken of this event and grant permission for said photos to be used for general church purposes (i.e. website, social media, etc).

Parent's Initials

Informed Consent and Acknowledgement--I hereby give my approval for my child’s participation in any and all activities prepared by Holliston UMC during the 2023 VBS. In exchange for the acceptance of said child’s candidacy by Holliston UMC, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Holliston UMC and all its respective employees, staff, and volunteers from any and all liability for accidental injuries, sickness or death (including but not limited to the effects of Covid 19) to said child arising out of participating in 2023 VBS. In case of injury to said child, I hereby waive all claims against Holliston UMC, including all church staff, volunteer assistants and affiliates, all participants, sponsoring agencies, and, if applicable, owners and lessors of premises used to conduct the event. Also, in the event that I cannot be reached in an emergency, I hereby give my permission to the physician or dentist selected by the church leadership to hospitalize, to secure proper treatment, and/or order an injection, anesthesia, or surgery for the child named above, as deemed necessary. I also agree to accept full financial responsibility for the cost of such treatment.*

Parent's Initials

By initialing below, I understand that my registration will not be complete until the fee is paid in full. Payment can be made below through PayPal. If not, you can submit payment by check (payable to: Holliston UMC (in Memo, write"VBS" and child(ren)'s name(s)).Checks can be submitted to P Ki or P Esther or mailed to: Holliston Children's Ministry (VBS), 1305 E. Colorado Blvd., Pasadena, CA 91106).*

Parent's Initials

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Parent's Signature*

My Products

Registration Fee (Before June 11th) - 1st Child ($30)

$30.00 Quantity

Registration Fee (Before June 11th) - Additional Child ($25)

$25.00 Quantity
Item subtotal:$0.00

Late Registration (After June 11th) - 1st Child ($35)

$35.00 Quantity

Late Registration (After June 11th) - Additional Child ($30)

$30.00 Quantity

Enter coupon

Total

$0.00

Pay with PayPal

Choose from one of the PayPal options to make your payment.

2023 Holliston UMC VBS Registration

Child's Information

Parent/Guardian Information

Emergency Contact Information