VBS Registration

VBS Registration 2022 (Hay Day)

Growing in Friendship with Jesus

Child's Name: *

Child's Age: *

Child's Date of Birth

Grade Entering In Fall: *

Child’s Shirt Size: *

Parent's Name: *

Cell Phone:

Home Phone:

Email: *

Allergies or other medical conditions:

In case of emergency, contact (name):

Emergency Phone Number:

Relationship to Child:

Photo Release (Please check box below if permission is given): *

I hereby grant Sandy Creek Congregations permission to use photographs/videos taken at VBS of the minor designated above on the Clifton Mills Church/Sandy Creek Congregation facebook pages, website, and newsletters . I realize that the name of my child will not be used with the photos/ videos, etc.

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VBS Registration

Clifton Mills

CLIFFTON MILLS, WV

Shady Grove

BRUCETON MILLS, WV

Hazelton

HAZELTON, WV