Clone of VBS Registration Form - Flushing Alliance Church

Rocket Racers Registration

Please fill out the form below and let us know if we have the go-ahead for this child's participation
June 22nd - 26th 5:30-8:00pm

Buckle up for Rocket Racers VBS — a high‑octane week where kids hit the track and their imaginations shift into overdrive! They’ll hear the roar of the crowd, feel the thunder of supercharged engines, and race through the power‑filled life of Elijah as they learn that even with adversaries and pit stops, God’s team wins in the end. All week long, kids will speed through high‑energy games, creative crafts, upbeat music, and Bible lessons that'll help them get on track with God. Then on Friday, families will return for our closing program to celebrate what the children have learned and enjoy food, fun, and the big Rocket Racers derby event, where each racer will have the chance to put their own customized pinewood derby car to the test. Sign up now and get ready to launch into an unforgettable Rocket Racers VBS!
- Participant Name*
  
  First NameLast Name
- Age*
- Date of Birth*
  
  MonthDayYear
- Grade Completed
- Medical Problems/ Allergies / Special Needs *
- Parent / Guardian's Name*
  
  First NameLast Name
- Who else may pick up your child at the close of the program each day?*
  
  First NameLast Name
- Phone Number (Daytime / Emergency)*
  Format: (000) 000-0000.
- Phone Number (Evening)
  Format: (000) 000-0000.
- E-mail*
  example@example.com
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip CodeCountry
- Do you currently have a home church?
  
  YesNo
- If Yes, where?
- Tell us how you learned about VBS at Flushing Alliance Church:
  
  Flushing Alliance Church WebsiteFacebookFlyer / PosterInvited by a friend
- CONSENT FOR MEDICAL TREATMENT | As the parent or legal guardian of the above-named participant, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.
- By signing and submitting this registraiton form, you understand and agree to all policies.
- Parent/Guardian Signature*
  
  First NameLast Name
- Today's Date*
  
  MonthDayYear
  Date
- Additional participants can be added here:
  Name - Grade they just finished - Allergies - DOB - Age
- Any questions please leave them here.
- Should be Empty:

Rocket Racers Registration

June 22nd - 26th 5:30-8:00pm