VBS Sign-Up Form Mount Moriah Charge/First Church of Nanticoke
Psalm 25:4 Shew me thy ways, O Lord; teach me thy paths.
Child's Date of Birth
Grade Just Completed
Street Address Line 2
State / Province
Postal / Zip Code
Please enter a valid phone number.
Emergency Contact Name and Phone Number:
Names of Guardians Responsible for Drop Off and Pick Up:
Please List Any Allergies:
I give permission to take photographs and / or video of my child. I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group's aims. Signature:
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