High Seas Expedition
First Presbyterian Church Vacation Bible School
305 North King Street
June 14-18, 2010 8:30 a.m.-12 noon
Ages 3 years thru 5th Grade
Child’s Name________________________________________________________________
Parent/Guardian Name________________________________________________________
Address____________________________________________________________________
___________________________________________________________________________
E-mail Address______________________________________________________________
Phone Numbers Home________________ Cell________________ Work____________
Age Information
Date of birth___________________________________
Last school grade completed______________________________________________
Allergies/Medical Information/Other Information We Need to Know:
Emergency Contacts
Name __________________________________ Phone__________________
Name _________________________________ Phone__________________
I give my permission for this child to participate in all VBS activities and release First Presbyterian Church and its staff and volunteers from any liability.
Signed:_________________________
Date:______________________
Circle one: Parent Guardian
The following people are authorized to pick up my child from VBS:
__________________________________________________________
_____ (Initial) By enrolling my child in Vacation Bible School at First Presbyterian Church I give the church permission to take pictures of my child for church promotions and publicity.
**As part of "Taking Care of God's Earth" we will be collecting items that can be recycled. Each day your child can bring aluminum. plastic, glass, and paper products that will be sent for recycling.
T-shirt size _____________ Child___ Adult___
Return form to 305 North King, Fax 379-5421, E-mail fpcseguin@att.net
