Vacation Bible School 2019

Vacation Bible School
July 29-August 2, 2019
6-8pm
New Heights Church
5501 Broad River Road
Columbia, SC 29212

All participants must be at least 4 years old on the first day of VBS (July 29, 2019), and be fully potty-trained. Please only register children for which you are the parent or legal guardian. Use a new form for each child. If you have any questions, please contact Julianne Ducharme at julianne@newheights.us.

Child Name

Birthdate

Child's Grade (2019/2020 school year)

Please select one option.

Pre-K (at least 4 years old and potty trained) Kindergarten 1st grade 2nd grade 3rd grade 4th grade 5th grade

Parent/Guardian Name(s)

This address will receive a confirmation email

Phone

Address

Emergency Contact

Emergency Contact Phone

I, as the parent or legal guardian of this child, give permission for my child to participate in all activities included in New Heights' Church's VBS program.

Please select all that apply.

Yes

I, as the parent or legal guardian of this child, authorize the leaders of New Heights Church to call a doctor or provide other necessary medical treatment should I not be reachable in the event of an emergency. I understand that I will be responsible for all medical costs incurred in such a situation, and will not hold New Heights Church or its leaders responsible for injury except in the case of gross negligence.

Please select all that apply.

Yes

I understand that New Heights staff and leaders may take photographs during VBS. These photos will be used for New Heights' website and Facebook page as well as promotional materials. I understand that my child's name will never be used in conjunction with any photos.

Please select all that apply.

Yes

Please list any allergies or other pertinent medical information that you would like us to know about your child:

Description

Vacation Bible School
July 29-August 2, 2019
6-8pm
New Heights Church
5501 Broad River Road
Columbia, SC 29212

Vacation Bible School 2019

Description

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