STARS IN THE UNIVERSE & KIDS CARE - ENROLLMENT

Wednesdays, 6:30-7:45pm, FALL through SPRING | Please fill out this form and click 'SUBMIT.'

Stars in the Universe is an original program, created by Dave Burkum, which invites children in Kindergarten through 5th grade to become more familiar with God and his Word through preaching and teaching, Bible literacy and memorization, one-on-one encouragement and prayer, and active games.

Please check ALL QUARTERS your family intends to participate. If your plans change, just let us know!

*

Please select all that apply.

Fall Quarter: September 13 - November 15 Winter Quarter: January 3 - February 28 (February 14th Ash Wednesday) Spring Quarter: March 13 - May 8 (skipping March 27 for Good Friday)

Parent / Guardian Information:

Name

*

Phone

*

Email

*

This address will receive a confirmation email

Address

Child Information

Please provide information for each child you would like to enroll.

1. Name

Grade

Please select one option.

Kindergarten 1st 2nd 3rd 4th 5th

Any allergies or medical/special concerns?

Check all that apply:

Please select all that apply.

I am re-enrolling This is my first time I need a new STARS Hat I need a new STARS Manual

2. Name

Grade

Please select one option.

Kindergarten 1st 2nd 3rd 4th 5th

Any allergies or medical/special concerns?

Check all that apply

Please select all that apply.

I am re-enrolling This is my first time I need a new STARS Hat I need a new STARS Manual

3. Name

Grade

Please select one option.

Kindergarten 1st 2nd 3rd 4th 5th

Any allergies or medical/special concerns?

Check all that apply

Please select all that apply.

I am re-enrolling This is my first time I need a new STARS Hat I need a new STARS Manual

KIDS CARE ENROLLMENT

Use this section if you have a child ages 3-5 (PreK), whom you would like to enroll in our Wednesday evening Kids Care where they will enjoy loving supervision of play.

1. Name

Age

Please select one option.

3 4 5

Any allergies or medical/special concerns?

If diapered, may we change them?

Please select one option.

Yes I'd rather you contact me

2. Name

Age

Please select one option.

3 4 5

Any allergies or medical/special concerns?

If diapered, may we change them?

Please select one option.

Yes I'd rather you contact me

By my submitting this form I indicate the following:

I am a parent or a legal guardian of the child(ren) listed.

I give permission for my child(ren) to participate in all activities at Valley Christian Church (VCC), unless I have otherwise noted.

I have disclosed any medical information concerning allergies or any other medical concerns / special instructions. I authorize VCC to get medical attention for my child in the event of an emergency.

I give permission for my child(ren) to be photographed or videoed during STARS activities, and I allow pictures or videos to be used in any VCC publications, advertisements, or social media.

Description

Wednesdays, 6:30-7:45pm, FALL through SPRING

Please fill out this form and click 'SUBMIT.'

Please Fix the Following

Close