Ecumenical VBS Registration Form

1. Granville Ecumenical VBS
JUNE 10-14, 2013 FROM 9 AM - NOON
PAGE 1
LITTLE VBS REGISTRATION FORM
for children of VBS Volunteers (Nursery—3 years of age)
Name:___________________________________ Age as of 6/1/13:____ Birth Date: _______ Gender: ___
Name:___________________________________ Age as of 6/1/13:____ Birth Date: _______ Gender: ___
Parent/Guardian:_____________________________________________ Home Phone:________________
Parent/Guardian:_____________________________________________ Home Phone:________________
Please explain in detail any special needs, food allergies or medical condiƟons of which we need to be aware.
Include symptoms to watch for, acƟons to be taken, specific instrucƟons for the administraƟon of any need-
ed medicaƟons (including epi-pens), and follow-up procedures.
Has your child had any previous group care experience (Church nursery, etc.)? Yes___ No ___
Please complete the other side of this form so we may make your child comfortable during VBS.
Permission to transport–name(s) of persons other than parent/guardian authorized to pick up your child:
Name: _______________________________________________ Phone: _________________________
Name:
Monday Tuesday Wednesday Thursday Friday
Please indicate the day(s) you need
childcare by wriƟng your volunteer
assignment in the appropriate boxes.
Contact us if you need care beyond these Ɵmes, and we will be happy to make arrangements.
CHILDCARE IS AVAILABLE:
Mon 8:15 - Noon Tues - Thurs 8:40 - Noon Fri 8:45-11:00
Reminder: Care for young children is provided for parents on the day(s) they volunteer.
Throughout the week your volunteer assignment may change. Please confirm any changes
with caregivers.
QuesƟons about VBSD Childcare? Contact Ellen Clark at 587-0178 or eclark@granpres.org.
This form must be completed and returned by May 31, 2013.
Return form to any sponsoring church or to Jody Sturgeon, VBS Registrar, 2420 Crestview Woods Court, Newark, OH 43055

2. GÙƒÄò®½½› E‘çÛĮ‘ƒ½ VBS
JUNE 10-14, 2013 FROM 9 AM - NOON
PAGE 2
LITTLE VBS REGISTRATION
for children of volunteers (Nursery—3 years of age)
Clearly indicate to which child you are referring or, for mulƟple children, please aƩach an extra copy of this page for your
second child.
Should your child nap during VBS? Yes ___ No ___
If yes, please describe your child’s nap rouƟne:
During VBVS, your child should wear? Diaper___ Pull-ups ___ Underpants ___
What should we know about his/her diapering needs/bathroom rouƟne?
For our infants and younger toddlers, we will provide plain Cheerios but request that you send in all other items including boƩles,
sippy cups and food with a spoon. For your younger child, please provide below the informaƟon needed regarding feeding sched-
ule, and indicate whether your child may be served Cheerios and/or the snack the older children receive in the preschool room.
What is the best way to comfort your child?
Is there anything else you would like us to know?
We plan to have some children parƟcipate in the daily morning assembly and in other acƟviƟes on the grounds.
May we take your child to other spaces? Yes ___ No ___
Will it be alright if your child sees your? Yes ___ No ___
Parent Name: _______________________________ Parent Signature ____________________________________ Date __________
QuesƟons about VBSD Childcare? Contact Ellen Clark at 587-0178 or eclark@granpres.org.
This form must be completed and returned by May 31, 2013.
Return form to any sponsoring church or to Jody Sturgeon, VBS Registrar, 2420 Crestview Woods Court, Newark, OH 43055