New Hope Church - VBS Registration 2023

New Hope Church VBS Registration

584 Colonial Club Drive, Harrisburg PA 17112 June 19th - 23rd from 6:30 - 8:30 pm (Check-in at 6pm each night) Ages 3 to 5th Grade Completed
We are so excited that you are sending your child(ren) on an "out of this world" adventure at New Hope Church! We understand that you may have multiple children to register, and we want to make it as simple as possible for you! Please complete the general information for all of your children on the first page, then complete the additional pages with specific information for each child. Do NOT hit submit until you have registered all children. We will be limiting registration again this year, so please tell your friends to register early! Any questions please email kjnoll@comcast.net. We are looking forward to an exciting, life-changing week!
Parent/Guardian Contact Information*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Home Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Mobile Phone*

Area CodePhone Number
New Hope Church puts your child(ren)'s safety and well-being above all else. For this reason we ask that all children remain under the supervision of staff until they are released from the program. We will not release your child(ren) to anyone unless you identify them. If at any time you would like to add another individual, please do so by submitting that person's name and contact information in writing to the program staff. Thank you!
Emergency Contact Name, Relationship, Phone Numbers*
Name and Contact information of person(s) authorized to pick up your child(ren):
Name of any person NOT AUTHORIZED to pick up your child(ren):
MEDICAL DISCLAIMER: New Hope Church staff and volunteers will not be administering any medications. If your child needs to use an inhaler or any other necessary medication they will be responsible to self-administer those medications under supervision. We will store the medication if/until it is needed, but ask that all medications brought be in their orginal packaging with the prescription intact.

I give my permission to the staff and volunteers of New Hope Church to seek medical attention for my child(ren) if necessary while participating at Vacation Bible School. I understand all necessary precautions will be taken for my child(ren)'s safety. I will not hold the church, its staff or those supervising liable.
Signature stating that you have read the medical disclaimer and give your child(ren) permission to participate. *
Type full name
Doctor's Name and Phone Number
MEDIA RELEASE: I provide consent for staff to photograph and record video of my child(ren) as they are participating in the program and to use any such photographic or electronic reproductions for purposes of brochures, website communications, video productions and other such media purposes for sharing New Hope's activities with our community. While I understand that no personal information will be included in that media, my child(ren) may be identifiable and that I may not be able to inspect or edit that media before it is released.
YesNo
Do you already attend worship services at another church? If so, would you be willing to share the name of your congregation?
How many children from the ages of 3 to 5th grade completed would you like to register? Do NOT hit submit until ALL children are registered.

New Hope Church VBS Registration

Children Registration: