VBS ON THE ROAD Registration Form

VBS On the Road Registration Form

Please fill the form below for each child that will be attending. (Child must have completed Kindergarten to attend.)
Participant (Child's) Name*

First NameLast Name
Child's Age (at the time of VBS)*
Child's Date of Birth*

MonthDayYear
Grade (please enter the grade the student just finished)
Medical Problems/ Allergies / Special Needs*
Parent / Guardian's Name*

First NameLast Name
Phone Number (Primary)*

Area CodePhone Number
Phone Number (Additional)

Area CodePhone Number
E-mail*
Address

Street Address

Street Address Line 2

CityState

Zip Code
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 licensed Doctor. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.
Parent/Guardian Signature or Initials*
CONSENT FOR TRANSPORTATION | I give my permission for my child (listed above) to ride the bus from the Thrive Church Kiwanis Lake Campus to Genesis Church (1405 Seven Valleys Road, York, PA) and back again for Vacation Bible School On the Road during the week of July 13-16, 2026.
OR

I will transport MY OWN child to and from VBS On The Road
Parent/Guardian Signature or Initials*
CHILD CONDUCT POLICY for Vacation Bible School

I understand that my child is expected to behave in a respectful, kind, and cooperative manner while attending and traveling to and from Vacation Bible School. This includes following directions from staff and volunteers, participating appropriately in activities, and treating others with care and respect. I acknowledge that disruptive or unsafe behavior may result in my child being removed from activities and I will be asked to pick up my child from said activities.

*Please have a conversation with your child about making good choices during this special week!
Parent/Guardian Signature or Initials*
Today's Date*

MonthDayYear
Comments and/or Questions:
Should be Empty:

VBS On the Road Registration Form