VBS REGISTRATION FORM

VBS REGISTRATION FORM
Green Pastures Presbyterian Church Vacation Bible School

Theme: Like Noah (Gen 6:8)

Jun 13 (Fri) – Jun 14 (Sat), 2025
9:00 am– 3:00 pm

Fee: $20 per child (includes snack, lunch, VBS t-shirt, VBS bag)
A registration fee of $20 per child must be submitted to complete the registration.

Send $20 through QR code / Recipient: Shinguk Choi

VBS Contact: Lily Han / lilyhan1110@gmail.com

Green Pastures Presbyterian Church  1948 The Alameda, San Jose, CA 95126
https://www.greenpastures-church.com/

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Venmo | Shinguk Choi -> Click
Zelle | Shinguk Choi
Green Pastures Presbyterian Church Vacation Bible School
Email *
Child's Name *
Child's Birth Date *
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Child's Grade (entering fall 2025) *
T-shirt Size Preference
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Child's Name
Child's Birth Date
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Child's Grade(entering fall 2025)
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T-shirt Size Preference
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Child's Name
Child's Birth Date
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DD
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YYYY
Child's Grade(entering fall 2025)
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T-shirt Size Preference
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Parent/Guardian Name(s) *
Parent/Guardian  Mobile *
Parent/Guardian  Email *
Emergency Contact *
Emergency Phone *
Allergies or Special Needs *
LIABILITY RELEASE :

In consideration of Green Pastures Presbyterian Church (“Church”) allowing the above child(ren) to participate in Vacation Bible School activities, I hereby release, discharge and agree to hold harmless Church, its directors, employees, volunteers and agents from any and all liability, claims or demands for accidental injury, sickness or damage and expenses, of any nature which may be incurred and the above child(ren) while involved in daily Vacation Bible School activities.
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Required

MEDICAL TREATMENT PERMISSION:

I give permission to Church to take whatever emergency measures that are judged necessary for the care and protection of my child while under the supervision of the Church.   

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Required
PHOTO/PICTURE PERMISSION: 

I give my consent to Church to use photo or video images taken of my child(ren) in Church brochures, advertisements for the Church, on the website, in social media, and in other Church publications as they see fit. 
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