IPC ER PYPA VBS REGISTRATION 2023

VBS Registration Form 2023

Welcome to the IPC ER PYPA VBS program! Our theme this year is "The Armor of God," and we can't wait to share with your children the importance of spiritual warfare and relying on God's strength and protection.Our program includes a variety of activities, including biblical teachings, worship, interactive activities, and even puppet shows! Your children will leave with a memorable and impactful experience that will equip them in their Christian journey.We'll be hosting VBS at India Christian Assembly of New York from August 23 - 25 and at India Christian Assembly of New Jersey from August 29 - 31 from 9 AM - 4 PM. Children from 4 years old to 14 years are welcome to attend.If you encounter any technical difficulties or have any questions, please don't hesitate to contact us at jointsecretary@pypaonline.org or 617-792-1941.We can't wait to see your children at our VBS program!
Parent Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail*
example@example.com
Mobile Number*
Home Phone
Church Name*
Enter the name of the church you attend
Child #1 Information
Child #1 Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
T Shirt Size*
Select T Shirt Size
Grade in September 2023*
Allergies*
Please enter any allergies your child has. If none, please enter NONE
Please let us know if your child has any special needs so we can better serve your child*
If no special needs, please enter NONE
Attending VBS location*
Will there be siblings attending the VBS?*

YesNo
Child #2 Information
Child #2 Name

First NameLast Name
Birth Date

MonthDayYear
Gender
T Shirt Size
Select T Shirt Size
Grade in September 2023
Allergies
Please enter any allergies your child has. If none, please enter NONE
Please let us know if your child has any special needs so we can better serve your child
If no special needs, please enter NONE
Attending VBS location
Child #3 Information
Child #3 Name

First NameLast Name
Birth Date

MonthDayYear
Gender
T Shirt Size
Select T Shirt Size
Grade in September 2023
Allergies
Please enter any allergies your child has. If none, please enter NONE
Please let us know if your child has any special needs so we can better serve your child
If no special needs, please enter NONE
Attending VBS location

Parental Waiver and Release of Liability
Name of Parent or Legal Guardian*

First NameLast Name
Signature*

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Date*

MonthDayYear
Date
Child #1 Name*

First NameLast Name
Child #2 Name

First NameLast Name
Child #3 Name

First NameLast Name
Payment *
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VBS Registration Fee $10
$10.00 Number of children attending VBS
Item subtotal:$0.00

Optional Donation If you would like to donate more for VBS, please donate here
$20.00
Item subtotal:$0.00

Total

$0.00
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VBS Registration Form 2023

Child #1 Information

Child #2 Information

Child #3 Information

Parental Waiver and Release of Liability