2018 VBS Registration

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At Shipwrecked, kids discover that Jesus rescues them!  Plan to join this week of fun!

Where: Aldersgate Church (397 Tyler Run Road, York, PA 17403)

When: Monday, July 16th through Friday, July 20th, 8:30am - 11:30am

Who: All children ages 4 through 5th grade.

Please register your child below (each child will need to be registered separately).

 

Child Information
Child's Name *
Child's Name
Gender
Grade child has just completed *
Parent/guardian information
Parent/Guardians Name
Parent/Guardians Name
Address
Address
Phone Number where you can be reached during VBS *
Phone Number where you can be reached during VBS
Secondary Phone Number
Secondary Phone Number
I hereby authorize event staff to obtain and give consent for medical treatment for my child for such injury or illness that may occur during the event, and hereby hold the event staff and their representatives harmless in the exercise of this authority. It is my understanding that the above named pariticipant will be covered by my personal medical insurance. The event provides limited/supplemental medical payment coverage for injuries arising out of the event activities which is payable in excess of any other collectible insurance. Payments of any medical injuries not covered by my insurance or the event limited/supplemental medical insurance will be paid by me. *
Do you give Aldersgate UMC permission to post photos or videos of your child on promotional materials? We will NOT include names of children with photos/videos. *