Manito United Methodist

Vacation Bible School

August 17-21
from 9am - 12pm

Diving Deep For God

Registration Form
(Please return to the church by August 5 or call in your information.)

Childs Name________________________________________________________________DOB ___________

School Attending___________________________ 2015 Grade Entering (K-6th Only )___________________
Parent/Guardians Name______________________________________________________________________
Parents are asked to volunteer at least 1 day, or donate food, and/or share some of your talents with us!
Mailing Address_______________________________________________________Zip code_______________
Phone Number _________________________Email Address_________________________________________
Emergency contact during Camp time:
____________________________________________________________________________________________
____________________________________________________________________________________________
Food Allergies/other limitations_________________________________________________________________
____________________________________________________________________________________________
Home Church_________________________ Interested in Volunteering? ______________________________
Please note: A church waiver must also be completed upon the childs first day of camp.
Presented by

Manito United Methodist Church

Grounded in Faith, Looking to the Future, Focused on Families
3220 S. Grand Blvd Spokane, WA 99203 Manitoumc@gmail.com
Phone: 747-4755
Mailing address: P.O. Box 8656 Spokane, WA 99203-0656 www.ManitoUMC.org

Date ________________________
Childs Name ______________________________
I understand that by signing below I release and hold harmless Manito United Methodist
church, and its owners, directors, officers, advisors, employees, agents, volunteers, childcare
workers, and all other persons or entities acting for them from any liability as a result of personal injury or property damage occurring while the above child/children is/are in their care
at Manito United Methodist Church. I understand that childcare services are provided free of
charge. I understand that if my child should become inconsolable during the class session, I
am responsible to come and remove my child.
I consent to have my child photographed and/or interviewed for the Manito United Methodist
Vacation Bible School Promotions and/or Sunday School Promotions. I understand and assume the specific risk that television, newspapers, Internet, or other media entities may use
my child's picture, likeness, or statements and that I will not have control over how this information may be disseminated or reproduced.

Custodial Parents Name _____________________________________________

Signature _________________________________________________________
Custodial Parents Name _____________________________________________
Signature _________________________________________________________