Kid's Quest Registration

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Kids' Quest Registration

Kids' Quest 2011: Time Travelers

Take a journey through time to learn about four major events in history—three that happened in the past and one that's yet to come! We'll learn about how God is working throughout history, and how Jesus is at the center of it all.

Kids 4 years old to those who just completed fifth grade are invited to join this very exciting VBS at Howdershell Park Pavilion, 6810 Howdershell Rd. in Hazelwood. And it’s all free!

Monday, August 1-Friday, August 5
9 a.m.-Noon daily

Family Information

Parent/Guardian:	*
Relationship to children:	*
Home phone:	*
Work phone:
Cell phone:
E-mail address:	*
Street address:	*
City/State/Zip:	, *
Home church:
Invited by:

Emergency Contact

Name:	*
Relationship to children:	*
Phone:	*

Child 1

Name:	* Male Female
Grade completed:
Name of school this fall:
Age:	*
Birth date:	*
Medical needs: (allergies, asthma, etc.)

Child 2

Name:	Male Female
Grade completed:
Name of school this fall:
Age:
Birth date:
Medical needs: (allergies, asthma, etc.)

Child 3

Name:	Male Female
Grade completed:
Name of school this fall:
Age:
Birth date:
Medical needs: (allergies, asthma, etc.)

Child 4

Name:	Male Female
Grade completed:
Name of school this fall:
Age:
Birth date:
Medical needs: (allergies, asthma, etc.)

Comments

Release waiver

I release the above children into the care and protection of Chatham Bible Church, recognizing that they will do everything possible to create a safe environment for my children. In the event that medical attention is needed, I give Chatham Bible Church permission to care for my child as appropriate. I understand that someone from Chatham will attempt to contact me as soon as possible in the event of an emergency.

Check this box to accept the above release waiver.

Chatham Bible Church | 6375 Howdershell Rd | Hazelwood, MO 63042 | 314.895.1850 | chathambc@sbcglobal.net

Last modified: January 23, 2012