©2019 Victory Assembly of God

Jasper, Indiana

Victoryagjasper@gmail.com

Kids Summer Wars Registration

DATE : JULY 15-17

TIME : 9AM - 3PM

PLACE : VICTORY ASSEMBLY OF GOD

CONTACT LEADER: 

Pastor Loretta Michel : (812) 630-9270

COST : FREE

Name(s)

has my permission to attend with the

Victory Kids Ministry

for the following activity :

SUMMER WARS

on the date(s) of July 15-17.

PLEASE CHECK WHICH GRADE YOUT CHILD(REN) WILL BE ENTERING:

Note: Child may not attend

if health form is not on file.

Print Health form and have in by DEADLINE JULY 7, 2019.

I understand the arrangements and also believe that necessary precautions and plans for the care and supervision of my child during the trip/activity will be taken. Beyond this, we will not hold Victory Assembly or those supervising the trip/activity responsible.

Parent/Guardian Signature

Date

Number(s) and email where you can be reached during the hours of this activity:

Home

Cell

Email

*Please notify the church if there have been any changes in your child’s health information.

I understand the arrangements and also believe that necessary precautions and plans for the 

care and supervision of my child during the trip / activity will be taken. Beyond this, we will not hold Victory Assembly of God or those supervising the trip / activity responsible.