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VBS Summer Sunday School 2016 July 17, 24, 31, Aug 7, 14 Aug 21-VBS Sunday Recap (9.30 am & 11.00 am) Children aged 3* - 10 years old Three year olds must be three by August and fully toilet trained Registration Form Child’s Name: __________________________ M / F DOB: _______________ Allergies or other significant medical conditions: _______________________ Child’s Name: __________________________ M / F DOB: _______________ Allergies or other significant medical conditions: _______________________ Child’s Name: __________________________ M / F DOB: _______________ Allergies or other significant medical conditions: _______________________ Full Postal Address: ________________________________________________ __________________________________________________________________ Home Tel: ___________________ Email: _______________________________ Parent or Caregiver’s Name: ____________________ Mobile: _____________ Emergency Contact Information Name: _________________ Phone: _____________ Relationship : _________

VBS 2016 Registration Form1586736fa27e4ac0a4e4-f7c9477480980a048131f829e766022f.r23.c… · VBS Summer Sunday School 2016 July 17, 24, 31, Aug 7, 14 Aug 21-VBS Sunday Recap (9.30

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Page 1: VBS 2016 Registration Form1586736fa27e4ac0a4e4-f7c9477480980a048131f829e766022f.r23.c… · VBS Summer Sunday School 2016 July 17, 24, 31, Aug 7, 14 Aug 21-VBS Sunday Recap (9.30

VBS Summer Sunday School 2016 July 17, 24, 31, Aug 7, 14

Aug 21-VBS Sunday Recap (9.30 am & 11.00 am)

Children aged 3* - 10 years old Three year olds must be three by August and fully toilet trained

Registration Form

Child’s Name: __________________________ M / F DOB: _______________

Allergies or other significant medical conditions: _______________________

Child’s Name: __________________________ M / F DOB: _______________

Allergies or other significant medical conditions: _______________________

Child’s Name: __________________________ M / F DOB: _______________

Allergies or other significant medical conditions: _______________________

Full Postal Address: ________________________________________________

__________________________________________________________________

Home Tel: ___________________ Email: _______________________________

Parent or Caregiver’s Name: ____________________ Mobile: _____________

Emergency Contact Information

Name: _________________ Phone: _____________ Relationship : _________

Page 2: VBS 2016 Registration Form1586736fa27e4ac0a4e4-f7c9477480980a048131f829e766022f.r23.c… · VBS Summer Sunday School 2016 July 17, 24, 31, Aug 7, 14 Aug 21-VBS Sunday Recap (9.30

Medical Consent: I (parent / guardian of the above named child/ren) give permission for Union Church adult supervisors to secure proper treatment for the health and comfort of my child until I can be reached

I have read and understand the above : Date: _________________________

Printed Name: ______________ Signature of Parent / Guardian: __________

Photo Release: I give permission for Union Church, HK to photograph my child at Egypt VBS Summer Sunday School 2016. I give permission to copyright, use and publish the photographs for any lawful purpose including newspaper articles, church publications and the church websites.

I have read and understand the above: Date: __________________________

Printed Name: _________________ Signature of Parent / Guardian: _______

Would like to volunteer for the event? Yes: ________ No: ________

If yes, please tick which Sunday : July 17: __ 24: __ 31: __ Aug 7: __ Aug 14: ___ 21: ___

Do you attend Union Church? Yes: _________ No: _________

How did you hear about our program ?________________________________

NO Registration Fees are required, instead we will run “A BagPack for A Child” campaign for children in Cambodia during this VBS Summer Sunday School. Families are encouraged to support a bag pack per child by donating the cost to purchase a bag pack plus stationery items in total of $100 per set. All proceed will go towards supporting the children of FCOP International in Cambodia.