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2022년도 Summer VBS
Event Timing: June 1-3th, 2022
Event Address: Siloam Korean Church of Atlanta
Contact us at Rev.박영호목사(470)848-4662
Registration Payment: VBS Registration - $ 40.00 per Child
Price:
First Child - $40
Second Child - 10% Off
Third Child - FREE
Schedule:
6/1 (Wed.) - 6/3 (Fri.)
오전 10시~오후 3시
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1. Child Name
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Child Birth Date
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DD
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YYYY
Child Male/Female
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Male
Female
2. Child Name (Second Child)
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Child Birth Date (Second Child)
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DD
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YYYY
Child Male/Female (Second Child)
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Female
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3. Child Name (Third Child)
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Child Birth Date (Third Child)
MM
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DD
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YYYY
Child Male/Female (Third Child)
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Female
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4. Parent/Guardian Name
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5. Parent/Guardian Phone Number
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6. Address
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7. Parent/Guardian E-mail
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8. Uniform Information
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9. More Uniform Information (other children's size except First Child)
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10. Medical Information (Physician Name)
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11. Medical Information (Physician Phone Number)
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12. Medical Conditions: If none please fill out this form with "N/A"
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Please check off the following conditions to indicate your acknowledgement and agreement to our policies:
*
I understand I will be responsible for transportation to and from the venue.
My child agrees to obey all the rules and regulations established by the leaders of any activities. These activities can include, but are not limited to, sports, limited running, and other group activities.
Should it be necessary for the participant to return home due to medical reasons, disciplinary action, or otherwise, I assume all transportation costs.
I also agree to be fully liable for any injuries and damages caused by my child and for any subsequent civic or criminal charges pressed against my child.
Child care beyond the time frame of VBS will be provided with an extra fee of $10/per child. Please contact our staff to schedule this service.
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Parent/Guardian Signature : (By signing I affirm that all of the information provided above is accurate.)
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