Hominy Valley

Vacation Bible School

Where? 

Hominy Valley Singing Grounds on Highway 151

When? 

Sunday, July 15th through Thursday, July 19th

What time?

Sunday only: Registration at 6:00pm

 Sunday - Thursday:  VBS @ 6:30-8:30

Who?

Preschoolers, age 3 to Elementary students, age 12

For more information call:

Karen Scarboro  (828) 667-5012

 

VBS Registration Form
Student’s Name ___________________________________________________________________________________
Parent/Family/Guardian Name _____________________________________________________________________
Address ___________________________________________________________________________________________________
_____________________________________________________________________________________________________
E-mail Address ___________________________________________________________________________________
Phone Numbers Home ______________________

Cell _____________________ Work____________________
Age Information
Date of birth _______________________________

Age ________________________
Last school grade completed ______________________________________________
Home Church _____________________________________________________________________________________
Friends of your child at this church _________________________________________________________________
Special Needs/Allergies/Medical Information/Other: ________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Emergency Contacts
Name _____________________________________________ Phone __________________________________
Name ___________________________________________

Phone __________________________________
Dismissal Information:
Name(s) of person(s) who may pick up this child from VBS
__________________________________________________________________________________________________
Other Information (church use only)
Rafter Group ____________________________________________________________________________________
Are parents/guardians/family members helping with Rolling River Rampage? ___________
If yes, where? _____________________________________________________________________________________
Rolling River Rampage Leader Resources