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FKPC Hybrid VBS 2021 - REGISTRATION FORM
Date: 8/19(Th) - 8/21(Sat)
Virtual: 8/19(Th) - 8/20(Fri)
Time: 10AM - 11AM
Saturday(8/21): Fun Day at Church!!
Time: 9AM - 1PM
Fee: $10 (Early bird until 7/31)
Contact: Kelly Lee JDSN (
kellylee9598@gmail.com
)
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* Indicates required question
Child’s name (이름)
*
Your answer
T-shirt size
*
XS (youth)
S (youth)
M (youth)
L (youth)
S (adult)
M (adult)
L (adult)
Child’s age (나이)
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Your answer
Date of birth (생년월일)
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MM
/
DD
/
YYYY
Grade Completed
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Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Other:
Name of parent(s) 부모님 성함
*
Your answer
Street address (주소)
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Your answer
City (address)
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Your answer
State (address)
*
Your answer
Zip Code (address)
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Your answer
Parent/Care giver’s cellphone (부모님핸드폰)
*
Your answer
E-mail address (이메일)
*
Your answer
HomeChurch (다니는교회)
*
Your answer
Emergency Health Information
Allergies or other medical conditions (알레지나 다른 병역)
*
Your answer
Emergency contact Name + Relation to Child + Phone number (위급연락 + 아이와관계 + 전화)
*
Your answer
I give the First Korean Presbyterian Church and its staff permission to care for and administer first-aid in the case of an injury and transport my child to a medical facility if deemed necessary. In the event of an emergency, I will be contacted and in no way hold FKPC or volunteers liable for any injury to my child.
*
Yes, I give my consent
No, I do not give my consent
Parent/Guardian Signature (Print name)
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Your answer
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