Anchored Vacation Bible School June 21-22, 2021

Dive Right In! Kids ages Toddler-8th grade will embark on an adventure, diving deeper in their faith and discovering God's unwavering love and faithfulness! Come Join us June 21-22 from 5:45 pm-8:30 pm. Dinner will take place at 5:45pm with VBS beginning at 6:30pm This year we are asking a responsible adult to stay with their kids during V.B.S. We are excited for your opportunity to grow and learn together at Anchored V.B.S.
If you have questions or would like to serve, plese contact Addie Maxwell at 989-631-1151 or addie@aldersgate.church

Family Name

Phone

This address will receive a confirmation email

Address

List Children's Name, Date of Birth, Last Grade Completed at School.

Adult(s) accompanying child

Will you be attending Dinner?

Yes No

Number Attending Dinner

Medical and Emergency Health Care Information

Does participant have food allergies?

Yes No

List Allergies

Does participant have physical, mental or medical issues that the staff should be aware of?

Yes No

Please describe what we should be aware of.

I understand that safety precautions will be taken by the church and its agents during this event. However, I understand that the possibility of injuries, unforeseen hazards and inherent risk exists. I agree not to hold the church, its employees, members and volunteers liable for and I release them from any damage, losses, diseases, or injuries incurred by the participant.

I agree I disagree

Name of Insurance Carrier

Insurance Group Number

Insurance Policy Number

Emergency Health Care

I authorize any emergency healthcare or treatment for my child, youth or vulnerable person that is deemed necessary by the Aldersgate VBS Event Coordinator. A prompt call will be made to the emergency contact numbers provided below.

Yes No

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship

Photo Release

I give permission for photographs, video and/or audio recordings to be used for publicity, including the internet, for Aldersgate Church Ministries

Yes No

Anchored Vacation Bible School June 21-22, 2021

Description

Please Fix the Following