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 newarkebenezerumc@verizon.net

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.