Zoomerang Vacation Bible School June 20-23, 2022
Please fill out this form and click submit.
Plan on being a part of Zoomerang
Vacation Bible School
@ the Midland Campus
- June 20-23, 5:45-8:30 pm. Dinner at 5:45 pm followed by VBS programming for Toddler - 8th grade & Adults.
We’ll marvel at the culture & beauty of Australia while we explore the wonder & value of life, from the lives of preborn babies to eternal life in the kingdom of God.We are looking for volunteers to serve. Please contact Addie Maxwell @ (989) 631-1151 or
addie@aldersgate.church
if you have any questions.
Family Name
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Phone
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Email
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Address
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List Children's Name, Date of Birth, Last Grade Completed at School.
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Adult(s) accompanying child
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Will you be attending Dinner?
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Please select all that apply.
Yes
No
Number Attending Dinner
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Medical and Emergency Health Care Information
Does participant have food allergies?
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Yes
No
List Allergies
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Does participant have physical, mental or medical issues that the staff should be aware of?
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Yes
No
Please describe what we should be aware of.
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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.
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Please select one option.
I agree
I disagree
Name of Insurance Carrier
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Insurance Group Number
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Insurance Policy Number
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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.
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Emergency Contact Name
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Emergency Contact Phone
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Emergency Contact Relationship
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Photo Release
I give permission for photographs, video and/or audio recordings to be used for publicity, including the internet, for Aldersgate Church Ministries
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