To Mars and Beyond Vacation Bible School

Bay Shore Church Vacation Bible School 2019

Join us for a fun full-day program incorporating music, dance, visual arts and crafts, games and special activities, Bible story time, worship, learning, and more!
WHERE: 5100 The Toledo, Long Beach

Bay Shore Community Congregational Church (UCC)
WHEN: Monday - Friday, June 17-21

Program 9:00 a.m. to 4:00 p.m. (early drop-off 8-9 a.m., late pick-up 4-5 p.m.)
WHO: Kids Age 4 Years Through 5th Grade

Youth entering 6th grade and up are welcome to register as helpers!
By submitting this form, you are giving your child permission to participate in this program and grant Bay Shore Church staff and volunteers permission to
supervise your child during program hours.

$100 suggested donation per child (payable by check or cash onsite on the first day of the program) Need-based scholarships are available (please contact me directly at the email address below)

Early drop-off and late pick-up available for $5 per instance
(no fee for Friday afternoon)

Fees waived for children or siblings of onsite volunteers.

Please send a packed lunch and snack with your child each day (labeled with your child's name). Some additional snacks will be available.

We invite your family to join us on Friday at 5:00 p.m. for a pizza dinner followed by a musical showcase of our week at 6:00 p.m. Your kids will be working towards this show all week, so you won't want to miss it!

We look forward to seeing you at VBS!
Susie Bjork, Associate Pastor
pastorsusie@bayshorechurch.org
Child's Name *

First Name Last Name
Child's Gender *
Child's Birth Date *

Month Day Year
Child's Grade in Fall 2019 *
Parent/Guardian's Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone *

Area Code Phone Number
Cell/Work Phone *

Area Code Phone Number
E-mail Address *
Additional Emergency Contact

First Name Last Name
Their Phone Number

Area Code Phone Number
Their Relationship to Your Child
Does anyone else have permission to pick up your child from VBS? *

Yes No
If so, what is their name?

First Name Last Name
Does your child have any allergies, dietary restrictions, or medical concerns that we need to be aware of? *
Does the church have your permission to use photos/video footage of your child at VBS for publicity purposes? *

Yes No
Is there anything else we should know about your child?
Should be Empty:

Bay Shore Church Vacation Bible School 2019

WHERE: 5100 The Toledo, Long Beach

WHEN: Monday - Friday, June 17-21

WHO: Kids Age 4 Years Through 5th Grade