Beach Lake FM Church
Home
About Us
What We Believe
What To Expect
Meet the Team
Location & Time
Ministries
Children
>
Dance Worship
Youth
Men & Women
Hands of Hope Boutique
Grief Share
Groups
Events
Sermons
Job Opportunities
Give
Operation Arctic VBS 2017 Registration
Please fill out the form below to register your child for Beach Lake FM Churchs' Operation Arctic VBS 2017. Please fill out one form per child. Thank you!
Explorer (Child) Information
*
Indicates required field
First and Last Name of Child
*
First
Last
[object Object]
Gender
*
Male
Female
Birthday
*
MM/DD/YYYY
Grade Completed
*
Preschool
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
Allergies, Medical Conditions and/or Special Instructions
*
The name of a friend your child would like to be grouped with.
*
Parent/Emergency Contact Info
First and Last Name of Parent or Guardian
*
First
Last
Phone Number
*
E-mail
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Emergency Contact (First and Last Name)
*
First
Last
Please give the name of someone who can be reached in an emergency if we cannot contact you.
Relationship of Emergency Contact to Child
*
Emergency Contact Phone #
*
What are the names of people to whom we can release your child?
*
Names separated by a comma
Church Affiliation
*
Beach Lake FM Church
Wallenpaupack FM Church
Community FM Church
Beach Lake UM Church
Tabernacle Bible Church
First Presbyterian Church Honesdale
Other
I do not attend a church at this time
Marketing Permissions
*
By checking this box, I agree to allow Beach Lake FM Church to use pictures or videos of my child in their advertising & promotion.
Liability and Medical release
The child listed on this form has my permission to attend and participate in Operation Arctic VBS 2017 at Beach Lake FM Church. I release Beach Lake FM Church and its volunteers/employees from all liability for any injury that may occur while on the premises at this time. I hereby authorize Beach Lake FM Church to administer basic First Aid to this child and to seek professional medical treatment if necessary. By checking the Liability and Medical Release box below, you agree to the above statement.
Liability and Medical Release
*
By checking this box, I agree to the liability and medical release statement above.
The child listed on this form has my permission to attend and participate in Cave Quest VBS 2016 at Beach Lake Free Methodist Church. I release Beach Lake Free Methodist Church and its volunteers/employees from all liability for any injury that may occur while on the premises at this time. I hereby authorize Beach Lake Free Methodist Church to administer basic First Aid to this child and to seek professional medical treatment if necessary.
Submit Registration
Home
About Us
What We Believe
What To Expect
Meet the Team
Location & Time
Ministries
Children
>
Dance Worship
Youth
Men & Women
Hands of Hope Boutique
Grief Share
Groups
Events
Sermons
Job Opportunities
Give
