photo 1
~ Vacation Bible School Registration ~


Please complete this form for each child you wish to register for the 2019 VBS program at Jonestown United Methodist Church.


Great Escapes

Great Escapes VBS
June 16-20 from 6 - 8:30 pm
Ages 4 through Grade 5

Let's BREAK out the Bible, ESCAPE into a few stories, and SOLVE the puzzle together!
For more information, call 717-865-4369 or 717-865-2848.

Please note the deadline for registration submissions is June 14th, 2019.



*  Parent (Full) Name:



*  Child (Full) Name:



*  Child Age:



Grade the Child Just Finished (if applicable):



E-mail Address:



*  Telephone:
Home:  
Cell:  


Address:



Emergency Contact (if different from above):



Allergies:



Comments/special instructions:



Photo Release:
  I hereby grant permission for my child/ren listed on this form to be included in pictures, promotional material, and publications connected with Vacation Bible School at Jonestown United Methodist Church. My child’s picture may be taken and appear in publications, such as, but not limited to, as follows: church newsletter, PowerPoint presentations, church’s website (www.jonestownumc.org), church brochures, postcards, and flyers.