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Delaware Grace

Location

375 Hills Miller Rd

Delaware, OH 43015

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Contact Jeff Edler:

740-363-3613

gracekids@delawaregrace.org

First, Tell Us About Yourself:

Parent Information

Welcome to Delaware Grace Vacation Bible School.

Each child will require an application. If that child is bringing a friend that friend will require an application as well.

Ages starting 4 years old -5th grade entering 6th grade

On 6/10 Check-in starts at 5:30pm

On 6/11-6/13 Check-in starts at 5:45pm

VBS officially starts at 6pm and will finish at 8pm each evening

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Contact Phone 2

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Text Message Phone

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup Phone

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Comments

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I understand that I or my child(ren) may appear in media used by Delaware Grace Church including, but not limited to: images, video, audio, print pieces, social media, websites, and text. I consent to the collection and use of such media by Delaware Grace Church.

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I agree to give my consent for emergency medical treatment for my child(ren) or myself. In the event of illness or injury requiring emergency treatment, I authorize church staff to seek treatment at the nearest available licensed physician or dentist, or transport to the nearest medical facility. I expect to be contacted as soon as possible if an emergency occurs. I hereby release Delaware Grace Church, its staff, volunteers from any responsibility and liability for any illness or injury that the above mentioned child may sustain during any activity and any and all claims and liabilities.

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

Child Name (One Form per Child)

First Name

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Last Name

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Grade Entering

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Gender

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Date Of Birth

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List Allergies,

Allergies

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List Medical Concerns

Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Comments

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