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The Congregational United Church of Christ
Serving St. Charles, Campton Hills and surrounding communities
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Donate
About
You Are Welcome
Our History
Staff
The United Church of Christ
Get Involved
Become a Member
Worship
Worship Schedule
Sermons
Light a Candle
Baptisms
Holy Communion
Weddings
Music Groups
Missions
Missions Committee
Manna Cards
Jesus Has Left The Building
Work Camp
Fellowship
Fun and Fellowship
Family Camp
Coffee Fellowship
St Patrick Parade
News
Highlight Newsletter
Photo Flash
Calendar
Events
Parlor Art
Submit New Content
Contact
Address and Phones
Contact a Staff Member
Directions
Donate
Vacation Bible School Registration 2017
Vacation Bible School Registration 2017
Instructions
Please submit a separate registration form for each child. Your $25 per child check may be mailed or dropped at the church office by June 19. Registration at the door increases to $30. Vacation Bible School, is for 4 years old through 5th Grade and will meet June 19-22 from 9 to 11:30am, and on June 22 from 5 to 7pm
First Name
*
Enter Child's First Name
Last Name
*
Enter Child's Last Name
Preferred Name
*
Enter Nickname or First Name Child Prefers
Gender
*
Please Check One
Male
Female
Other
Date of Birth
*
Date Format mm/dd/yy
School Grade Entering
*
What Grade in the Fall?
Parent(s)/Guardian
*
Please enter full name(s) of parent(s) or Guardian
Church Relationship
*
Member
Friend
Volunteers
*
Is Parent/Guardian Available to help?
Yes
No
Volunteer Child Care
If volunteering, do you need child care for younger children?
Yes
No
Scholarship
Check if you require a scholarship for the registration fee.
Need Scholarship
Cell Phone
Please enter parent/guardian Cell #
Home Phone
*
Enter home number, even if same as cell
Email
*
Parent/Guardian email address
Medical Notes
*
List allergies or other conditions which may limit activity. If none, please write, "none."
Must be between
1
and
150
words. Total words:
0
Emergency Contact
*
In case of emergency, who should we contact, and how should we contact them?
Must be between
2
and
150
words. Total words:
0
T-shirt size
*
Please select your child's T-shirt size
Youth XS
Youth S
Youth M
Youth L
Adult XS
Adult S
Adult M
Adult L
Adult XL
Verification
Please enter any two digits
Example: 12
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please leave it blank