VBS 2017

  • Please enter a value between 0 and 5.
  • Parent/Guardian Information

  • Other persons authorized to pick up your child after VBS

  • Emergency Contact

    In Case of emergency (if primary parent/guardian cannot be reached) please contact:
  • Special Medical or Dietary Restictions

  • (e.g., allergies to medicine or food, chronic illnesses, or other conditions)
  • prescription and/or over the counter
  • I GIVE PERMISSION FOR MY CHILD TO PARTICIPATE IN VACATION BIBLE SCHOOL, JUNE 25-29, 2017

    I hereby give permission for the Presbyterian Church of Western Spring to procure all necessary medical help for my child while he/she is under direct supervision of the Presbyterian Church of Western Springs, and grand permission to its representatives to authorize any competent medical person to do all things necessary to take care of any injury or sickness while my child is under the supervision of the Presbyterian Church of Western Springs.