Vacation Bible School

Colossal Coaster World

New Hope Baptist Church

1401 Loveland Madeira Road ● Loveland, Ohio 45140

Sunday, July 28 - Friday, August 2, 2013 ● 6:30 PM - 9:15 PM

SECTION 1: CHILD INFORMATION

Child Name:

Boy Girl

Birth Date: Age: Grade Completed:

Known allergies?

SECTION 2: PARENT/GUARDIAN INFORMATION

Parent/Guardian Name:

Preferred Email Contact:

Address:

City: State: Zip:

Home Phone:

Mobile Phone:

Other Phone:

SECTION 3: EMERGENCY CONTACT INFORMATION (IF OTHER THAN PARENT/GUARDIAN ABOVE)

Emergency Contact:

Phone:

SECTION 4: PICK UP INFORMATION

Other than any adult listed above, who may pick up your child at the end of each VBS night? Please include phone number if not listed above.

Name 1:

Name 1 Phone:

Name 2:

Name 2 Phone:

Name 3:

Name 3 Phone:

SECTION 5: MISCELLANEOUS

1st through 4th Grade Only: Name of a friend I'd like to be in class with (same grade only). Though highly considered, class requests cannot be guaranteed.

Friend Name:

Do you attend Sunday School or Church? If so where?

Church Name:

If you are visiting our church, are you a guest of someone?

Name:

May we have permission to photograph your child? Yes No

May we use your child's photograph in church promotions? Yes No

How did you hear about this year's VBS at New Hope?

When done, please click the Submit Form button below. If you need to make a change after submitting, please email web@newhopeonthehill.com and describe changes. You will receive a confirmation that the change was made.