Embark - Vacation Bible School

Monday, July 13, 2015 9:00 PM 21:00
Friday, July 17, 2015 12:00 PM 12:00

Google Calendar ICS

The Darkness is coming, and where Darkness descends, chaos ensues. Will the crew of the Starship Ephesus have what it takes to defeat The Darkness, or will they too fall under its shadow?

EMBARK with us on an adventure through time and space as we seek the One who can restore light.

EMBARK Student Registration Form

Child Name

First Name

Last Name

Age

Date of Birth

YYYY

2015-16 Grade

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

Parent/Guardian Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(daytime number - mobile preferred)

(###)

###

####

Emergency Contact

First Name

Last Name

Emergency Contact Number

(###)

###

####

Special Needs/Allergies

If no special needs or allergies, please enter "None"

To the best of my knowledge my child is physically and emotionally able to take part in the Vacation Bible School program. In the event of a medical emergency, I give permission to the volunteer medical person selected by Racine Christian Church to do whatever is necessary for the health of my child named on this form. (We will attempt to contact you or the emergency contact.) I hereby release Racine Christian Church from any responsibility other than normal supervision and care. In case of an accident, i will not hold Racine Christian Church, their staff, members or volunteers liable.

I recognize this is a Christian church event, that the Bible will be studied, and that VBS conduct will be expected that is consistent with Christian values.

I give my permission for any appropriate photographs/videos to be used for current and future rKids promotional purposes.

Signature

Typing your name will serve as your signature.

Date

YYYY