Vacation Bible School
Registration

Name:

Age:

Last School Year Completed: 

Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

E-Mail Address:

Mother's Name:

Father's Name:

Emergency Contacts:

Allergies/Medical Conditions:

Home Church:

YES, we will attend the Family Snack Suppers.
Number Attending:
Please Check the nights you will attend: Mon  Tues  Wed  Thurs

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PERMISSION SLIP FOR MISSION MANIACS
(ONLY 5TH & 6TH GRADERS NEED TO COMPLETE)

I, the parent/guardian of , give my permission for him/her to ride the Cabot United Methodist Church van or other volunteer vehicle to any of the 2008 Mission Maniac activities.  I release the Cabot United Methodist Church and chaperones from liability.  In case of a medical emergency involving my child, I give the Cabot United Methodist Church permission to obtain medical treatment for my child.  I will be responsible for the physician and/or hospital fees.  I grant permission to any qualified medical facility to administer emergency and/or lifesaving treatment.  I also grant permission to place my child in an emergency vehicle for transportation to the nearest emergency medical facility.

Parent:

Date:

Mission Maniac T-Shirts:

I already have a Mission Maniac T-Shirt
I will need a Mission Maniac T-Shirt
    Size: