VBS 2025 Registration • Jefferson Christian Church

When: July 27 - 30

Time: 6pm-8pm

Where: 8200 Jefferson Church Road

Who: 3 year olds - rising 6th graders

What: Worship, lessons, small groups and games

Dinner begins at 5pm.

CHILD'S INFO

First Name *

Last Name *

Date of Birth *

Grade Entering *

Allergies and Medical Concerns *

Choose Event *

VBS (8200 Jefferson Church Road)
Jul 27, 2025 12:00 AM
Cancel Accept Decline

Do you want to register another child? *

Yes

PARENT'S INFO

Parent's Name *

Address *

Home Church

Email Address *

Mobile Number *

EMERGENCY CONTACT IN CASE A PARENT CANNOT BE REACHED

Emergency Contact Name *

Emergency Contact Relation to Child *

Emergency Contact Phone Number *

With my signature below, 1) As parent or legal guardian, I hereby grant my permission for my child to fully participate in VBS at Jefferson Christian Church; 2) In the event of an emergency, I authorize first aid or medical treatment for this child/these children and I release Jefferson Christian Church from any and all responsibility in connection therewith; 3) I understand that my child's photograph may be used in publications and promotional materials.

Signature *