Vacation Bible Adventure

Sunday, July 13 — Thursday, July 17, 6:00 – 8:30 pm. 

For children entering 1st-6th grades. Music, Stories, and lot’s of Fun Activities. (Don’t miss the Moonbounce Opening Night!)

Children enjoy a FREE DINNER at 6:00 pm. 

Please pre-register by filling out form below, by email: woodlyn@rcn.com, or call us: 610-833-5577

Please enable JavaScript in your browser to complete this form.

First and Last Name for each child listed below

Child's First/Last Name *

Date of Birth *

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Grade *

Allergies/Medical Conditions

Add another child?NoYes

Child's First/Last Name *

Date of Birth *

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Grade *

Allergies/Medical Conditions

Add another child?NoYes

Child's First/Last Name *

Date of Birth *

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Grade *

Allergies/Medical Conditions

Add another child?NoYes

Child's First/Last Name *

Date of Birth *

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Grade *

Allergies/Medical Conditions

Add another child?NoYes

Child's First/Last Name *

Date of Birth *

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Grade *

Allergies/Medical Conditions

Home Address *

Address Line 1

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

In Case of Emergency, Notify:

First/Last Name #1 *

Relationship to Children *

Home Phone

Cell Phone

First/Last Name #2 *

Relationship to Children *

Home Phone

Cell Phone

I would like to authorize the following person(s) to pick up my child from this activity: *

Is there any other information you would like us to know in order to serve your child better?

How did you hear about our Vacation Bible Adventure?

Home church?

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