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Ebenezer United Methodist Church & Resurrection Parish
Vacation Bible School 2019
Monday - Friday
June 1
from 9
7– 21, 2019:00 AM to 12:00 PM
at Ebenezer United Methodist Church,
525 Polly Drummond Hill Road, Newark
For children ages 4—11 (or completed 5th grade)
Registration closes Sunday, June 2, 2019
Registration Form
Please complete a separate form for EACH child . Please PRINT CLEARLY; legible contact information is vital in the event of an emergency!
Child’s First and Last Name: _________________________________________________________
Child’s age: ________ Birthdate: ______/_______/________ Going INTO grade: _______
Child’s gender M___ T-shirt Size: YXS___ YM___ YXL___ AS___
Parent or Guardian: __________________________________________________________________
Primary Contact #:_____________________________ Secondary #: ______________________
Email Address: _______________________________________________________________________
Mailing Address: _____________________________________________________________________
My child would like to be in a group with: __________________________________________
We will do our best, but cannot promise to put friends or relatives together. We must group students by age/grade for
curriculum purposes, are limited to class size based on room capacity and number of adult volunteers, and will make
assignments based on order of receipt of registration. Thank you for understanding.
Who will pick up your child from VBS? Your child must be signed in and out of VBS each day.
Our VBS team are all volunteers. Please make sure your child is picked up promptly at noon each day.
__________________________________________________ Relation to child: _________________
_____________________________________________ Relation to child: _________________
$20 activity fee per child; $60 max per family
TURN OVER TO COMPLETE & SIGN FORM
F___ YS___ YL___
Child’s Physician: _______________________________________ Phone: __________________
Please list food or other allergies: ______________________________________________
If your child has a food allergy, you are responsible for sending a safe snack for your child to VBS each day.
Medications or other information the VBS team should know about your child:
_______________________________________________________________________________
Emergency Contact (if parent or guardian cannot be reached): _____________________________________
Phone: ___________________________________ Relation to child: _____________________
Our procedure if your child becomes sick or injured at VBS:
1. Ebenezer United Methodist Church (EUMC) will call the parent’s/guardian’s primary number, then secondary
number, and then the emergency contact number.
2. If there is no answer at any of the provided numbers, EUMC will call an ambulance to transport child to a medical
facility. A designated EUMC adult will accompany the child to the medical facility.
3. Child may be treated and/or admitted based upon medical judgment of the attending physician at medical facility.
4. EUMC will continue calling the parent/guardian and emergency contact until one is reached.
May we photograph your child during VBS? Yes____ NO____Photos may be used during closing celebration slide show and may appear on the Ebenezer and/or Resurrection
websites, Facebook pages or bulletin boards. Photos may also be used as part of classroom craft projects. Camper
Please sign below and mail or drop off this completed form, along with $20 cash or a check
payable to Ebenezer United Methodist Church (memo: VBS registration) to:
Ebenezer United Methodist Church, c/o VBS Registrar, 525 Polly Drummond Hill Road, Newark DE 19711.
You may combine activity fees for all children in one family on the same check, but please include a separate
completed form for each child. Amount enclosed: $__________ Check Number: ___________
PLEASE NOTE BEFORE SIGNING:
For the safety of our children, Ebenezer United Methodist Church and Resurrection Parish have for years required
thorough courthouse-acquired background checks for all adult VBS volunteers in compliance with our Safe Sanctuaries
policy. However, we must make you aware that we are not in full compliance with The Joseph R. “Beau” Biden III Child
Protection Act, which took effect April 7, 2016. Your signature acknowledges your awareness of this.
_____________________________________________________________ ______________________________
Signature of Parent or Guardian Date
For more information, call the Ebenezer United Methodist Church office at (302) 731-9495
or email [email protected]
Space is limited so register today! We are sorry, but the church secretary cannot register or hold space for your child
by phone or email. Your child will be considered registered when your form and activity fee are received in the church
office. You may mail or drop off your completed form and activity fee Monday – Thursday 9 to 4; Friday 9 to 12; or
join us for worship services Sundays at 8:30 and 11 a.m. and drop them off then!
No registrations will be accepted after Sunday, June 2, 2019Curriculum and supplies are ordered in advance. NO WALK-INS will be accepted during VBS week.
Camper Cell Phone Policy: Children should not be using their cellphone or electronic devices during VBS activities. Please ensure Child's cellphone/electronic device is kept in a safe place during VBS hours.