Vacation Bible School Signup Form

Bethel Baptist Church

Vacation Bible School Signup Form
Name of Child 1

First NameLast Name
Age Child 1
Grade Level Child 1 Finished
Name of Child 2

First NameLast Name
Age Child 2
Grade Level Child 2 Finished
Name of Child 3

First NameLast Name
Age Child 3
Grade Level Child 3 Finished
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Does your children have any allergies?

YesNo
What are the allergies of each child?
Does your children have any medical condition that we should be aware of?

YesNo
What is this medical condition? Please elaborate below:
We have a BUS. Would you be interested in this service?

YesNo
Pick Up Authorization

Authorized person/s to pickup your child after the Vacation Bible Study
Full Name 1

First NameLast Name
Relationship
Full Name 2

First NameLast Name
Relationship
Parent Contact Information
Parent Contact

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Reminders
- I allow my child to participate in this program.
- I hereby authorize the school, bible study conductor, volunteer personnel to conduct first aid, and medical care in the event of an emergency situation.
- I release the organizers from any liabilities that might happen during the activity and hold them harmless in the event of damages, injuries, or accidents.
- I confirm that all information in this form is accurate and true to the best of my knowledge.
Would it be okay if we take photos and videos of the participant during the activity which will be posted in our social media account?

YesNo
Date

MonthDayYear
Date
Parent/Guardian Signature

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Date Signed

MonthDayYear
Date

SUNDAY JULY 20 - 24TH

6:30 - 8:30 PM

Nightly Dinner Menus / Dress up Info

Day 1 ~ Sunday – Come as you are night!

Honeycomb Waffles (Frozen Waffles)

               Bumblebee Sausage Bits (Small Link Sausage)

               Wildberries (Strawberries & Blueberries)

Day 2 ~ Monday – Favorite Bug, Insect or Color

               Caged Snakes (Baked Spaghetti)

               Garden Party (Salad)

               Flowers (Butter Cookies)

Day 3 ~ Tuesday – Wacky Shoes / Tacky Socks

               Nachos Gone Wild (Walking Tacos)

               Wormy Dirt Pudding (Chocolate Pudding w/Gummy Worms)

Day 4 ~ Wednesday – Inside out Day

               Nug Life (Chicken Nuggets)

               Beetles (Chips)

               God Given Veggies (Carrots & Ranch)

               Magnifying Glass (Mini Donut with Pretzel Handle)

Day 5 ~ Family Night – Wilderness Day

               Magnified Pizza

               Lady Bug Sundae (Ice Cream Sundae)

Beverages:

               Liquid Sunshine (Lemonade)

               Rainwater (Water)

               Pouch-Tastic (Capri Suns)

               O Yeah Kool (Kool Aid)
Should be Empty:

Bethel Baptist Church

Pick Up Authorization

Parent Contact Information

Reminders

SUNDAY JULY 20 - 24TH

6:30 - 8:30 PM

Nightly Dinner Menus / Dress up Info