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Dayspring Church

2305 N. Indiana Ave
Auburn, IN, 46706
United States

 
 

Dayspring Kids Presents: Polar Blast VBS

For Children Ages: 3 years to 5th grade

June 22: 6:00PM-8:30PM

June 23: 10:00AM-12:30PM

June 24: 9:30AM or 11:15 AM

 

Kids chill with new friends and warm up to Jesus at Dayspring Kids Polar Blast Vacation Bible School. Sled into an ice way to spend the ultimate summer weekend learning Jesus' Love Is Cool!

If you have additional questions please contact:

Kelly Strong

Pastor of Dayspring Kids 

260-925-4599 ext. 106

kellys@dayspringchurch.com

 

Parent/Guardian Name *
Parent/Guardian Name
Home Address *
Home Address
Phone Number *
Phone Number
Please provide a number that is easiest to reach you at incase of an emergency.
Secondary Phone Number
Secondary Phone Number
Please provide a secondary phone number that a parent or guardian can be reached at in case of an ememrgancy.
We have some wonderful opportunities to contribute as a volunteer during VBS. Please indicate if you would be interested in taking advantage of this wonderful opportunity.
Name of 1st Child *
Name of 1st Child
Birthdate 1st Child *
Birthdate 1st Child
Please take a moment to tell us any allergies or restrictions that your 1st child may have that will need to be accomodated.
Please choose your child's t-shirt size
Celebration Gathering Time *
Please indicate which celebration Sunday Gathering your child will be attending for our last day of VBS.
Name of 2nd Child
Name of 2nd Child
Birthdate 2nd Child
Birthdate 2nd Child
Please take a moment to tell us any allergies or restrictions that your 2nd child may have that will need to be accommodated.
Celebration Gathering Time
Please indicate which celebration Sunday Gathering your child will be attending for our last day of VBS.
Name of 3rd Child
Name of 3rd Child
Birthdate 3rd Child
Birthdate 3rd Child
Please take a moment to tell us any allergies or restrictions that your 3rd child may have that will need to be accommodated.
Celebration Gathering Time
Please indicate which celebration Sunday Gathering your child will be attending for our last day of VBS.
Name of 4th Child
Name of 4th Child
Birthdate 4th Child
Birthdate 4th Child
Please take a moment to tell us any allergies or restrictions that your 4th child may have that will need to be accommodated.
Celebration Gathering Time
Please indicate which celebration Sunday Gathering your child will be attending for our last day of VBS.
Photo Release *
I agree that Dayspring Community Church, may use photographs or video of my child/children or myself with or without their name and for any lawful purposes, including for example publicity, illustration, advertising, and Web content.
As the parent or legal guardian of the above named child/children, I hereby give permission for my child/children to participate in the Dayspring Church Kids VBS Program. I understand that Dayspring Church is a nonprofit charitable institution, which is voluntarily presenting this program for my child/children, other participants, and the community. I also understand that the program has activities that can involve physical contact with other participants, the ground or equipment, and that there is a resulting risk of physical injury to my child/children. I have explained these risks and benefits of participating in this program to my child/children and my child/children are in proper physical condition and have no existing injuries or conditions that could jeopardize his/her safety or health, or the safety or health of the other participants. I, therefore, release and discharge all liability for any harm or injury suffered directly or indirectly as a result of my child/children's participation in the Dayspring Church Kids VBS Program, whether or not resulting from negligence, and I agree not to sue Dayspring Church, its representatives, staff, or volunteers on any such claim. I also give permission for the staff, representative, or volunteers of Dayspring Church to administer first aid or to seek medical care for my child during my child's participation in the program, including transportation of my child to a medical facility for additional treatment that appears necessary. *By typing my name and date below I hereby consent to the above document.