Shiloh
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    • 2nd Annual Cool Weather Picnic
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  • Home
  • About Us
    • What We Believe
    • Our Staff
    • Our Gatherings
    • Our Ministries >
      • Children
      • Teen
      • College
      • International
      • Senior
      • Music
      • Spanish Speaking
    • Our Supported Missions
  • Events Calendar
  • Photo Gallery
    • Church Renovation Before
    • Renovation After
    • 2016 Spring Picnic
    • 2016 VBS
    • 2nd Annual Cool Weather Picnic
  • Media
  • Contact
Shiloh

VBS Registration

    Child Information



    Medical Information


    Transportation

    If "yes" for van service:

    Disclaimer for liability on riding the van:
    I hereby give my consent that any necessary treatment may be given to my child by medical personnel in case of an accident or illness while at VBS, in town or in route to or from Shiloh Missionary Baptist Church of Russellville.

    I understand that payments for medical care will be my responsibility. I also do hereby release Shiloh Missionary Baptist Church of Russellville or any of its agents from any claim of liability arising from their normal duties as sponsors on the trip.

    ​

    Disclaimer for media

    I understand that as a Participant, I or my child may be photographed or videotaped during all VBS activities, and these photo/videos may be used for promotional purposes.
Submit Registration

Location

4060 North Arkansas
Russellville, Arkansas

Telephone

479.968.1753

Email                             

shilohrussellville@gmail.com