Acts 2:42 church (formerly CMCC)

VACATION BIBLE SCHOOL Application– Sonworld Adventure park

JUNE 26-30, 2017; 8:30 A.M. TO 4 P.M.

Snacks and lunch provided.
Open to Children ages 4-12; Registration is FREE but must register ASAP
(First come, first serve basis – limit of 50 kids)

CHILD (ren)’s Information

Name: / DOB: / Grade Completed:
Name: / DOB: / Grade Completed:
Name: / DOB: / Grade Completed:
Name: / DOB: / Grade Completed:
T-shirt size: / Child 1: ______Child 2: ______child 3: ______Child 4: ______
Current address:
City: / State: MD / ZIP Code:
Name of church, if any

Emergency Contact

Name of Parent(s):
Parent(s) Phone: / Email:
In case of Emergency, contact: / Relationship:
Who can pick up your child other than parents/legal guardian(w/ phone number):


Can your child participate in the Grand Finale on June 30th @ 4:30 p.m. (circle one): Yes No
I hereby GRANTDONOT GRANT (circle one) permission for Acts2:42 Church to use pictures of my child(ren) on their website for informational or promotional purposes.


Allergies or other medical conditions( separate application if more than 1 child has allergies)
Physician’s Name and Phone number
Does your child have any medical or special needs, including medications currently being used?
List any food allergies:


Kitchen help / Craft / Lunch break
Teacher’s help / Provide snacks/lunch / Recess (soon after lunch)
Dismissal help / Other / Days/Hours you can volunteer:


I (we), the undersigned parent(s) or guardian(s) of ______do hereby release Acts242 church from any liability in the event of an accident enroute, during and returning from any recreational activity.
Signature of parent/guardian Date
Mail/email application to:Acts2:42 Church, 3229 Corporate Court, Ellicott City, MD 21042
Rev. Daniel R. Israel; Phone: 443-684-2287;
Email: ; website: