VBS 2016 ON-LINE REGISTRATION FORM

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This form is designed to allow for EARLY REGISTRATION of your child/children to attend Vacation Bible School at Emmanuel and prevent standing in a' pre-registration line' on May 22 or 'late-registration line' on June 6. (Complete individual form for each child!)

"OCEAN COMMOTION" EXPERIENCE AT EMMANUEL VBS!

Date of Registration: *

Registrant's Name *

Registrant's Age (as of June 1, 2016): *

Registrant's Grade (2015-2016 school year): *

Parents' Names: *

Parents' Contact Info (phone numbers, emergency only): *

If age 12 or completed grade 6, may opt to PARTICIPATE (as student) or ASSIST (as helper, if opening available) in VBS:

PARTICIPATE as student in VBS

ASSIST as helper in VBS

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Please list all ALLERGIES (food-drug-insect-other): *

We learned about Emmanuel's VBS program via:

Emmanuel's Members

Emmanuel's Programs (AWANA,, EDGE, WOMEN'S MINISTRY)

Emmanuel Website and/or E-Mail

Newspaper and/or Word of Mouth

Other:

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Permission to contact parents about other Emmanuel programs:

Yes, thank you, please do.

No, thank you.

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Request a phone or personal contact from Emmanuel's Pastor and/or Elder:

Yes, thank you.

No, thank you.

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Submit

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