Wonder Junction at New Hope OPC

Family Information

Parent/Guardian Last Name

Parent/Guardian First Name

Contact Information

Street

Street 2

City

State/Province

Postal Code

Primary Phone

Alternate Phone

Emergency Contact during VBS

Emergency Contact

Relationship to Student

Phone Number

Waiver

By typing my name in the box below, I agree to the following:

1) In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by New Hope Presbyterian Church to hospitalize, secure proper treatment for, and order injection, anesthesia or surgery for the child named above. 2) New Hope Presbyterian Church reserves the right to publish VBS photographs on our church website and local community publications.

Signature

Do you attend a church?

New Hope OPC

Other

Details

None

Are you willing to volunteer during VBS?

If you check yes, you will be contacted to gather more information.

Yes

I already have and I can't wait!

Register for VBS