Coventry COB 2021 VBS --- Rocky Railway

Who: 4 years old through 5th grade (completed 5th grade)
When: Monday, July 26th through Friday, July 31st, 6-8:30pm
Where: Coventry Church of the Brethren (946 Keen Rd. Pottstown, PA 19465)

*Masks will be optional for all children and staff. We will be both inside and outside throughout the evening. Please do not send children who are not healthy.

*Snacks will be prepackaged (Except for food at the Family Fun Night on Friday) and nut-free.

PARENT INFORMATION

Parent Name:

Email:

This address will receive a confirmation email

Phone:

Address:

Additional Parent Name:

Additional Parent Phone:

Church Regularly Attend if any:

CHILD INFORMATION

Eligible Children: Age 4 (by July 31st, 2021) through 5th grade (completed 5th grade)

List Children Attending - Full Name, Birthdate, Grade Completed and T-shirt Size:

List any allergies/medical information (specify child):

EMERGENCY CONTACT INFORMATION

Emergency Contact:

Relationship to Child/Children:

Emergency Contact Phone:

Name & Phone # of anyone other than parents who have permission to pick up your child:

PERMISSIONS

I, the parent or legal guardian of the above named, allow him/her to attend VBS. I recognize the risk involved in activities and will not hold the Coventry COB, its staff or volunteers, responsible for any personal injury that might occur to my child while participating in this program. I authorize a staff member or volunteer from the church to seek and obtain such emergency or medical services for my child as deemed necessary at the time.

I Agree I Disagree (*disagreeing to this statement will not allow your child/children to attend Coventry Church of the Brethren's VBS)

I give my permission for my child/children to appear on Coventry Church of the Brethren's website, Facebook page and/or other promotions.

I Agree I Do Not Agree

Description

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Coventry COB 2021 VBS --- Rocky Railway

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