Vacation Bible School Registration | Valmont Community Presbyterian Church

Dates:
Monday, July 21 through Thursday, July 24

Hours:
9 a.m. to 12:00 p.m.

Location:
Valmont Church, 3262 N. 61st Street, Boulder, Colorado 80301

Ages:
Entering First Grade through Entering Fifth Grade

Cost:
$10.00 per child or $15 per family. Scholarships are available.

To register, click here to download the form, or fill out and submit the electronic form below. If registering online, you will still need to mail the registration fee to the church.
Return your registration/fee to the church by July 18.

Registration Information

Child(renʼs) Names and Ages: *
Address / City / Zip: *
Email *
Parent / Guardian Name(s): *
Day Phone: *
Evening Phone: *
Persons authorized to pick up child: *
Persons NOT AUTHORIZED to pick up child:
Please list all food allergens:
Any other information we need to know:
Transportation Release: I give permission for the participant(s) named above to be transported by Valmont or Highlands staff / volunteers in approved vehicles on and off premises for program activities and medical care. If there is an emergency, the parent / guardian and 911 will be called.
My child(ren) will only be be able to attend (please check):
[Please go ahead and register your child if one or both are needed. We will call you to coordinate.]:if a scholarship is providedif transportation is provided

Parent/Guardian Signature

I attest that all information provided is true and accurate. *
I Agree
Mail in by the due date:
• the fee -- $10/child or $15/family (unless requesting a scholarship)
• copy of the child's insurance card (both sides)

Mail to
Attn: VBS
Valmont Community Presbyterian Church
3262 61st Street Boulder, Colorado 80301

Questions? Please call 303-442-2135

Please print the form for your records.

Verification

Please enter any two digits with no spaces (Example: 12) *
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