VBS 2024

Ages 4 through Grade 6

Monday, June 24th – Friday, June 28th

Daily from 6:00pm – 8:30pm

PLEASE FILL IN THE SIGNUP FORM FOR EACH CHILD BELOW.

The online signup form for our 2024 Vacation Bible School has closed. Please feel free to contact Pastor David Beecher at (904) 501-1745 if you have any questions or need to do a last minute signup.

Thank you!

Child's Information

Child's Full Name *

Sex *

Fall School Grade *

Birthday *

Age as of Start of VBS *

Mother's Information

Mother's Full Name

Mother's Address

Mother's Cell Phone

Mother, May we Text You?

Mother's Email Address

Mother, May we Email You?

Father's Information

Father's Full Name

Father's Address

Father's Cell Phone

Father, May we Text You?

Father's Email Address

Father, May we Email You?

Permission for Alternate Pick up other than Mother or Father -- Optional

Full Name

Relationship

Cell / Home Phone

May we Text You?

Child's Medical Information

Allergic to any Medications? *

Diabetic? *

Convulsive Disorder? *

Asthma? *

Allergies? *

Tetanus Shot Current? *

CONSENT FOR MEDICAL TREATMENT
By signing my name below, I give permission for the staff of Mill Creek Baptist Church to obtain and administer such medical aid, including that of a licensed MD, as might be required for the immediate care of my child in an emergency. I understand that every effort will be made to contact me.

Mother's or Father's Signature *

Vacation Bible School Signup