2015 Registration Form - “SonSpark Labs” VBS
March 16 - 20, 2015 9:00 a.m. – 12 noon daily @3350 Weston Road
A Free VBS for kids 4-11
Call Weston Road Church for more info: 416.741.3558
PARENT/GUARDIAN INFORMATION
FAMILY (LAST) NAME: ______FIRST NAME: ______
Address: ______Postal Code: ______
Home Phone: ______Work Phone:______
Cell Phone #1:______Cell Phone #2: ______
Alternate Contact Name for Drop off / Pick up: ______
CHILDREN’S INFORMATION
T-shirt size (circle one)
1. CHILD’S NAME: ______Grade: _____ S M L XL
Date of Birth ______Allergies/health concerns: ______
If possible, please place______(child’s name) in the same group as ______
(children are grouped according to age and not all requests may be granted)
T-shirt size (circle one)
2 . CHILD’S NAME: ______Grade: _____ S M L XL
Date of Birth ______Allergies/health concerns: ______
If possible, please place______(child’s name) in the same group as ______(children are grouped according to age and not all requests may be granted)
Consent: The parents or guardians completing this form are those having legal custody over the child(ren). Conditions of custody, if applicable, must be fully communicated in writing to Weston Road Pentecostal Church including, if applicable, a photocopy of the section of any court order referring to visitation rights. I hereby give permission for Weston Road Pentecostal Church to use any pictures or video taken at this event for publication. If you do not wish your child(ren) to be photographed, please check this box.
No Photographs ð No Video
I the parent/guardian of the child(ren) named above have read, understood and accepted the Consent terms stated above.
Parent/ Guardian Name: ______
Parent/ Guardian Signature: ______Date: ______