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______________________
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. Page 2 of 2