Independent Presbyterian Church
Thursday, May 23, 2013

2013 Preschool Vacation Bible School

"Everywhere Fun Fair"

For preschool children who have completed classes for 3s, 4s and 5k 
June 10-14, 2013
9:00 a.m. to 12:00 noon
at Independent Presbyterian Church
Cost per child/week   $20.00
  
Registration:
Member priority through April 17, 2013
Open registration- April 17 – May 17, 2013 
 
Catherine Pringle, Co-Chair and Jessica Meriwether, Co-Chair of VBS.
 
Click here to print out registration form, fill it out by hand, and return it to Sally Speaker.
  OR
 
 
 IPC Vacation Bible School Registration
"Everywhere Fun Fair"  2013
Registration Deadline is May 17, 2013.
IPC members have first priority until April 17, 2013
 
Please register ONE CHILD PER FORM ONLY
 
ABOUT YOUR CHILD:
Child's Name:     
Address:            
Phone:               
Girl:     
Boy:     
Age: 
Birth Date: 
T-Shirt Size:   X-Small (2-4)     Small (6-8)    
School:         
Class Completed as of May 2012:
  3s   
  4s  
  Kindergarten 
Are you a member of IPC?   Yes:               No:  
  If not a member, other church affiliation: 
List one special fried attending VBS:                
  (We will try to honor one friend request)
 
CONTACT INFORMATION:
Mom's Name:   
Mom's Phone:  
Mom's Cell:        
Mom willing to serve:    Yes:         No:
 
Dad's Name:       
Dad's Phone:      
Dad's Cell:         
Dad willing to serve:   Yes:        No:
 
I would like to serve in:
  Art                       
  Recreation           
  Teaching              
  Teachers' Snacks
 
As a volunteer, I will need childcare
        for any younger child/children:   Yes:        No:
 
Comments: 
 
Email addresses:  (We will send daily updates and important informtion to you via email.)
   Mom's Email:  
   Dad's Email:      
 
Pediatrician's Name:  
Pediatrician's Phone: 
 
Special Health conditions/Allergies for your child: 
Medication to be given from CLEARLY labeled container:
   Dosage:       Time: 
 
 
REGISTRATION:
The Registration fee for VBS is $20 per child to cover the cost of a sing-along CD and a tee shirt for each child.
Please make your check payable to IPC.
 
Pictures of children having fun at VBS will be placed on IPC's website. Names will not be used.
Yes:      I do give permission for pictures of my child to be used.
No:        I do not give permission for pictures of my child to be used. 
 
Insurance Co/Policy-Group No.:    
 
PERMISSION:  MUST HAVE SIGNATURE
NOTE:  After you click "Submit" below, you will be directed to a signature page.
On that page, you must click on the short document, print it, and sign (handwritten) the brief signature page.
After signing that form, please give that hand-signed form and your check to Sally Speaker.
 
NOW, CLICK "SUBMIT" to send all of the above information to Sally Speaker
 
 
 
 
 
Questions?   Contact Sally Speaker (933-3724)