Vacation Bible School 2024
June 17th-19th, 9am-12pm
For children entering Kindergarten - 5th grade
Parent or Guardian (required)
*
First Name
Last Name
Phone Number (required)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email (required)
*
example@example.com
Child #1 (required)
*
First Name
Last Name
Gender - Child #1 (required)
*
Male
Female
School Grade starting in the fall - Child #1
*
Kindergarten
First grade
Second grade
Third grade
Fourth grade
Fifth grade
Preschool (Children of VBS Staff Only)
Child #2
First Name
Last Name
Gender - Child #2
Male
Female
School Grade starting in the fall - Child #2
Kindergarten
First grade
Second grade
Third grade
Fourth grade
Fifth grade
Preschool (Children of VBS Staff Only)
Child #3
First Name
Last Name
Gender - Child #3
Male
Female
School Grade starting in the fall - Child #3
Kindergarten
First grade
Second grade
Third grade
Fourth grade
Fifth grade
Preschool (Children of VBS Staff Only)
Child #4
First Name
Last Name
Gender - Child #4
Male
Female
School Grade starting in the fall - Child #4
Kindergarten
First grade
Second grade
Third grade
Fourth grade
Fifth grade
Preschool (Children of VBS Staff Only)
Medical Information we need to know - include any allergies
*
Emergency Contact (required)
*
First Name
Last Name
Emergency Phone Number (required)
*
Format: (000) 000-0000.
Dismissal Information - List the names of those who have your permission to pick up your child by 12pm
*
Permission to use your child's photograph in future VBS promotional material by Mountainside Church of Christ
*
Yes, you have my permission
No, you do not have my permission
VBS Liability Waiver 2024 (required)
Vacation Bible School involves similar risks as leaving your child at daycare or school. I hereby give my permission for my child/children (listed above) to participate in Vacation Bible School, June 17th-19th, 2024 which is run and/or operated by Mountainside Church of Christ. I waive, release and discharge, indemnify and hold harmless Mountainside Church of Christ, its agents, employees, officers, directors, affiliates, successors, managers, members, and volunteers and releases from all liability for or by reason of any damage, loss or injury to person and property, even injury resulting in death of the child, which has been or may be sustained in consequence of the child's participation in the activities of VBS, and not withstanding that such damage, loss or injury may have been caused solely or partly by the negligence either active or passive of the Mountainside Church of Christ.
*
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