| But God Ministries (Sponsor)

Child's Name*

First Middle Last

The name s/he go by*

Address*

Street Address Address Line 2 City State ZIP Code

Parent Name*

First Middle Last

Home Phone

Cell Phone*

Work Phone

Email Address*

Child's Date of Birth*

Grade Completed*

Please Check your Child’s T-Shirt Size*

Has your child ever attended Jonestown Montessori School?*

yes
no

Please tell us anything important that we should know about your child:*

Emergency Contact Information

Emergency Contact #1*

Phone for Emergency Contact #1*

Street Address for Emergency Contact #1*

Emergency Contact #2*

Phone for Emergency Contact #2*

Street Address for Emergency Contact #2*

Does your child have any allergies or medical conditions that we should be aware of?*

Jonestown VBS 2022 - June 7- June 30, 2022

* Breakfast will be served from 7:30am-8:30am and lunch will be served from 12:30pm-1:30pm. Both breakfast and lunch must both be served on site so there will not be a to-go lunch.

Please select the boxes indicating the camps that you would like your child to attend

June 7-9, 2022 VBS Cooking Arts & Crafts Camp
June 14-16, 2022 VBS
June 21-23, 2022 VBS
June 28-30, 2022 VBS Arts & Crafts and Sports Camp

VBS Liability and Permission Form

Signature*

Understand that by signing this form you are stating that all the information you have given on this form is true and that you agree with the VACATION BIBLE SCHOOL LIABILITY AND PERMISSION FORM.

Date Signed*

2022 Vacation Bible School Registration

Emergency Contact Information

Jonestown VBS 2022 - June 7- June 30, 2022

VBS Liability and Permission Form