Download - 2013 EBC VBS Flyer and Reg. Form
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7/28/2019 2013 EBC VBS Flyer and Reg. Form
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_____________________________________________For God has not given us a spirit of fearfulness, but one of power, love, and
sound judgment. 2 Timothy 1:7
Bible StoriesGamesPrizesCraftsMusicFood
* Transportation will be available everyday to and from the church(If transportation is needed, make note of this on your registration form)
_____________________________________________For more information call Jesse Motley: 580-482-1775 or
Email: [email protected]
Please return Registration Form and Medical Release form to:
Emmanuel Baptist Church
800 North Forrest St.
Altus, OK 73521
Vacation Bible School
Emmanuel Baptist Church
Pre-K 6th Grade(completed)
July 15th 19th
Monday Friday
9:00 am 12:00 pm
* Free Snack provided everyday *
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Registration
FormChildsName
Parent/GuardianName
Address
(street address,city, state,and zip code)
Mailing Address(ifdifferent)
Phone NumbersHome
WorkCell
Email
Age Information
Birthdate
Lastgrade completed in school
Medical Information
Medical or other information we need to know. (Please include any
food allergies.)
Emergency Contacts(Other than listed above.)
Name Phone number_
Name Phonenumber_
Does your child need transportation? Yes No
Dismissal Information
Who may pick up your child at the end of each VBS day?
Other InformationDoes your child attend Sunday School? Ifso where?
Ifyour child is visiting our church, who is he/she a guest of?
May we have permission tophotograph your child? Yes No
May we have permission to use your childsphotograph forthe
purpose of promotion? Yes No
Administrative Guide CD, Registration Form 2012, LifeWay Christian Resources of the Southern Baptist Convention
VBS 2013 Published in the United States of America OK to Copy
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Emmanuel Baptist Church
Pastor: Boyd Whitehead
PARENTAL CONSENT AND MEDI CAL AUTHORIZATION: FI ELD TRIPS
I, ____________________________________________, the parent or legal guardian of
______________________________________________ do give consent to the participation of the child named
above for the year of 2013. I give consent for my child, listed above, to take part in any or all the activities,including but not limited to physical or athletic activities for the youth or children at Emmanuel Baptist Church,Altus, Oklahoma, including field trips.
______________________________________ _________________Signature of Parent/Guardian Date
______________________________________ _________________
Address Phone Number
MEDICAL TREATMENT AUTHORIZATION
I understand that I will be notified in the case of a medical emergency involving my child listed above. However,in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medicalservices in the event my child, listed above, is injured or becomes ill. I understand that Emmanuel Baptist Churchwill not be responsible as parent/guardian.
I agree to notify the church in the event of any health changes which would restrict my childs participation in any normal
youth activities. I also understand that the adult supervisors reserve the right to restrict my child from any activity that they
feel is not within the physical capabilities of my child.
___________________________Insurance Company
___________________________Insurance Company ID/Medicaid Number
___________________________ ____________Signature of Parent/Guardian Date
Emmanuel Baptist Church
800 North Forrest
Altus, OK 73521
(580)-482-1775