This is the Church Medical Release Form

Please print this and return with payment for any event you are participating in.

Church Medical Release

VBS 2017 Registration Form

Church Wide Mission Trip Registration

Name *
Address *
Phone *
Select the days you plan to be at the site: *
First come, first serve as bus space is limited to 30. Only payment in full will secure your space on the bus. Additional bus fee of $50pp will be applied to the cost.
Team preference *
Please indicate which of the following teams you most want to be involved with.
Child's Name *
Child's Name
If no allergies, please put N/A
Second Child's Name
Second Child's Name
Please skip if N/A
Third Child's Name
Third Child's Name
Please skip if N/A
Parent/ Guardian *
Parent/ Guardian
Home Phone *
Home Phone
Mobile Phone *
Mobile Phone