Vacation Bible School

17955 W 3rd Street . Elliston, OH . 43432 419.862.3417 tucc1862@gmail.com

Family City, State, Zip Code: *

By registering my child for this event, I give my consent for my child to participate in all activities associated with Trinity UCC's VBS. In good faith, I agree not to hold Trinity UCC or any representative responsible for any injuries, incidences or medical expenses associated with their participation in this event. I understand that staff, volunteers and leaders will make every attempt to contact me as soon as possible if an emergency arises. If I cannot be reached, I give Trinity UCC's staff, volunteers and leaders authorization to take my child to a doctor or hospital at my own expense. I understand that my child may be videotaped or photographed as part of this event and this media may be used in promotional materials for Trinity UCC in print/web form. *

Name of your home church *

Parent Email: *

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Family Home Phone: *

Child's Date of Birth (MM/DD/YYYY): *

Family Street Address: *

Parent Cell Phone: *

Does child have any allergies (food, medication, environmental) or medical condition we should be aware of during VBS?: *

Parent's Name(s): *

Child's Last School Grade Completed: *

Child's Name (First & Last): *

Click here to download a printable registration form that you can fill in and bring to the church to register your child for VBS.

Fill in the online form below and submit to register your child.

Please fill out a separate form for each child.

Child's Current Age: *

Emergency Contact Name & Relationship To Child: *

Emergency Contact Phone Number: *