2025 Vacation Bible School Registration Form

Vacation Bible School June 23, 24 & 25

Online registration ends Friday, June 20, 2025.
2025 Vacation Bible School Registration

Pastor: Rev. Jameson K. McLaughlin; Asst. Pastor: Rev. Darlene Smalls;

Christian Ed. Dir: Phaedra McLaughlin; VBS Dir: Jacquetta McCoy
Child's Information
Child's Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date

MonthDayYear
Current Grade*
Allergies (include Food) If no allergies enter "None"*
Parent/Guardian Information
Name of Parent Guardian*

First NameMiddle NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Name of Parent Guardian #2

First NameMiddle NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
**If the parent/guardian will not be dropping off/picking up student, please give name of adult who has permission to do so.
Name

First NameLast Name
Code of Conduct

Expectations:

1.     Student will follow the directions of all teachers and church leaders.

2.     Student will be respectful of others and of church property

3.     Student will not have in his/her possession any substances or materials that are illegal or harmful to others.

4.     Student will not behave in a manner that is disruptive or abusive to others.

5.     Student will be honest in all dealings with others.

Consequences:

1.     Student will be given a warning.

2.     A conference will be scheduled with student.

3.     A conference will be scheduled with parent/guardian.

4.     A disciplinary notice will be placed in student’s file.

5.     A conference with the Christian Ed. Dir or Pastor will be scheduled to discuss further actions.

**FYI - The consequences will not necessarily occur in the order listed above. Consequences depend on the severity of the infraction committed.
Image Consent - Occasionally photo/video footage may be taken of students participating in activities in the church. These images may be used in one or more of the following: announcement screens in the sanctuary or Family Life Center, bulletin, newsletter, church website, or social media sites.*

I give my child consent to have his/her image used for church-related publicityI DO NOT give my child consent to have his/her image used for church-related publicity
Confirmation

Please sign below acknowledging you read and understand the expectations and consequences.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Vacation Bible School June 23, 24 & 25

Child's Information