Wonder Junction at Mt. Moriah Church

Family Information

Address

Street

Street 2

City

State/Province

Postal Code

Parent/Guardian First Name

Parent/Guardian Last Name

Primary Phone

Alternate Phone

Emergency Contact

Relationship to Student

Phone Number

Recordings/Pictures I hereby grant permission for Mt. Moriah church to record sounds, images, or video of my child/children listed above while attending this vbs program. I also give permission for Mt. Moriah Church at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Mt. Moriah Church. Please type your name below as a digital signature.

Liability I also release Mt. Moriah Church from responsibility for any and all injuries incurred during vacation bible school. Please type your name below as a digital signature.

Pick Up Please list who may pick up your child from VBS.

** Kindergarten Registration

Kindergarten cowboys and cowgirls can be registered, in person, at the church registration desk any night of VBS.

Register for VBS

at Mt. Moriah Church

Family Information

Address

Student Information