Church of the Holy Cross
2455 Gallows Road
Dunn Loring, VA 22027-1225

703.698.6991

Vacation Bible School Registration

June 25-29, 2018 9:00 a.m. - Noon, minimum age 4 years

Parent Information

Mother's Name Cell
Email
Father's Name Cell
Email
Srtreet Address City
State Zip
Home Phone
Emergency Contact - available during VBS (9 am -12 pm)
Name
Phone

Camper/Youth Helper 1

Name Name for badge
Date of Birth Grade in
fall '18
Medical conditions/concerns or allergies

Camper/Youth Helper 2

Name Name for badge
Date of Birth Grade in
fall '18
Medical conditions/concerns or allergies

Camper/Youth Helper 3

Name Name for badge
Date of Birth Grade in
fall '18
Medical conditions/concerns or allergies

Camper/Youth Helper 4

Name Name for badge
Date of Birth Grade in
fall '18
Medical conditions/concerns or allergies

Volunteer to make the week great!

Parent Name I will serve on the VBS planning team

I would like to help with:

(check all that apply)










I can’t volunteer my time, but I can make a financial contribution.
Do you agree to allow photos of your child(ren) to be used on the church web site, Facebook page and/or any church promotional materials?
Pay Online If you would like to pay online using a credit card or a PayPal account, you will be able to on the next page after you submit this form.
      
     


VBS Fees:

  • $45 per camper
  • $70 for two
  • Youth Leaders no charge

If paying by check, please make it payable to Episcopal Church of the Holy Cross.

Scholarships available. Please contact Nick Lodico for info on scholarships.