Member of the Presbyterian Church of America

The Game Plan - 2008 Vacation Bible School

June 24 thru 27, from 9 a.m. to 1 p.m.

Your Child's Name:

Grade entering:      Age:   

Address: 

Telephone Number:

Your Email Address:

Emergency Name & Number  

T-shirt Size (child)  please write S M L (adult)  

Any Allergies: 

or Special Needs:

Do you attend a church in town?  Y / N   If so, where?  

How did you hear about VBS 008?  

Photo Release Aggrement: I understand that by registering my child for CCC VBS 008, I give permission for my child to be photographed and/or videotaped for promotional use and CCC viewing. Photos may be posted on our website.

Medical Release Agreement: I consent to any medical care deemed necessary in the event I can not be contacted. I further release CCC from all liability from any injury or accident that may occur during this event.

Parent/Guardian Name:  

printing your name on the above line will be necessary for the agreements.

$10 fee per child & $25 per family (3 or more children)

Thank you!