VBS REGISTRATION

Services

Sunday - 9.30AM Sunday School, 10.30AM Worship Service, 5.00PM Bible Study | Wednesday - 6.30PM Bible Study & Youth

Registration Form

Pre-K – 5th Grade 

[register teens as helpers]

 

Please include the following completed information in the message area below:

Child’s Name ________________________________Age__________ Birth Date ______________________Grade Completed this Year_____

Child’s Name ________________________________Age__________ Birth Date ______________________Grade Completed this Year_____

Child’s Name ________________________________Age__________ Birth Date ______________________Grade Completed this Year_____

Child’s Name ________________________________Age__________ Birth Date ______________________Grade Completed this Year_____

List Name & Allergies:

WAVIER SIGNED BELOW???     YES             NO    

PARENT/GUARDIAN NAME[last, first]: ____________________________________________________

Address ___________________________________________________________________________________

City/State _____________________________________________________________Zip Code___________

Phone___________________________________________________________________

Cell Phone_________________________________________________________________________________

Email Address______________________________________________________________________________

Emergency Contact Name/Phone__________________________________________________________(Where to be reached during VBS)                                        

I/We presently attend which church _______________________________________________________

I/We would like to be contacted by Dale City Baptist Church:      YES □       NO 

Waiver & Permission Slip

I give permission for the above-named child(ren) to participate in games and any other Vacation Bible School activities at Dale City Baptist Church on July 26-30, 2021. I also give my permission to use pictures taken at VBS. I release Dale City Baptist Church and the workers involved from any possible liability.  

□ Check if permission is NOT GIVEN TO USE PICTURES of my child on the website and advertising.  

 I give permission for my child to participate in games and other VBS activities.


Signature/Digital: _______________________________________________ Date: _____________         

By sending this email, you are certifying that you are the parent/legal guardian of the child(ren) being registered. 

You may alternatively print this form and sign, and submit to Mrs Missy Myles, DCB VBS Director