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Bradford Wood

ds Community Church Pre


esents:

2015 Vacation Bible School


July 28 July 30, 9:30 AM Noon
Bradford Woods Community Church
Post Office Box 421
4836 Wexford Run Rd.
Bradford Woods, PA 15015
(724) 935
935-3135, bwcc@consolidated.net

Children ages 4 through those entering 8th grade welcomed!


welcomed
Registration:: $15/child
$15/child; Registration deadline is July
ly 24
Please return this form along with registration fees to the Church office. Checks
should be made payable to Bradford Woods Community Church. Registration is
non-refundable. Please call or email the Church
urch office with any questions.
questions
Name______________________

Fall 2015 Grade ___

Name______________________

Fall 2015 Grade ___

Name______________________

Fall 2015 Grade ___

Name______________________

Fall 2015 Grade ___

Address____________________________________________________

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Parents Names___________________Email Address_______________________


Home Phone_______________________Cell phone________________________
Alternate Emergency Contact:
Name__________________________ Phone___________________________
Please list any allergies for each child (food, medicine, stings, etc).
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Please list all regular medications for each child ____________________________
___________________________________________________________________
Any other medical concerns ___________________________________________
___________________________________________________________________
In case of emergency, every effort will be made to contact parents first. A parents
signature on this form is required and constitutes authority for Bradford Woods
Community Church volunteer staff to transport the above-mentioned child or
children to UPMC Cranberry and agreement to have the necessary medical care
rendered. Signature of the parent likewise constitutes release of Bradford Woods
Community Church volunteer staff from any and all liability arising from treatment
or difference in treatment of existing disease or existing conditions not
enumerated on this form.
Weather permitting, some activities will be outdoors. All activities will be held on
BWCC grounds. Staff cell phone numbers may be called at any time during VBS.
Carla Porterfield
Norma Liebenguth

724-312-1162
724-494-3064

Signature of Parent or Guardian________________________________


Date_____________ Check # or Cash___________________________
Please check this box if you are interested in helping with VBS.
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