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Fill out all of the information requested and hit the Submit button—soon you’ll receive via e-mail a copy of your submitted registration form and a separate e-mail containing your Welcome Letter.

Registration forms will be accepted on a first-come, first-serve basis until June 1st, 2021. 

We have opened another Grade 3 and 4 class, but most of out age groups are very close to closing!

Register now for CONCRETE & CRANES: VBS 2021
  • Please fill out a separate application for each child.

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    The above-named child has permission to participate in the CONCRETE & CRANES! VBS Program at Addisville Reformed Church. If we cannot be reached in the event of an emergency, the following person is authorized to act on our child's behalf.
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    In the case of a medical emergency, I understand every effort will be made to contact a parent/guardian or the above-named authorized person. In the event we cannot be reached, permission is given for emergency treatment for my child.
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    If someone other than a parent/guardian will be picking up your child, please provide the following information about that person: name, relationship to child, and phone number where he/she may be reached. NOTE: This person will need to show photo ID in order for your child to be released to him/her. 
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    Please use the section below to list any special information, concerns or health/medical conditions for your child, including allergies. In terms of allergens, please note that snacks provided during the week include Goldfish crackers, OREO cookies, Chips Ahoy cookies, and hard pretzels. 
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    Please read before signing. During VBS activities at Addisville Reformed Church, pictures and video are taken of the participants. These pictures and video are sometimes used to promote and/or inform others about the activities that have taken place during VBS. We use our website, brochures and other media in doing so. Care is always given to show appropriate material, but we cannot control how others will use this material. This is especially true with web-related content. By signing below, you are acknowledging that pictures and/or video may be taken of you and your child and you are giving Addisville Reformed Church permission to use them in various media presentations. You also understand the risks involved and, except for gross negligence on the part of the church, you (the participant or parent/guardian) agree to hold harmless the Addisville Reformed Church for any outcome that results from the material being used. If a dispute over this agreement or any other claim for damage arises, you (the participant or parent/guardian) agree to resolve the matter through a mutually-acceptable arbitration process.

    If you do not sign below, you understand that pictures and/or video will still be taken, but we will not use the pictures and/or video in brochures, on our website, or in any future mailings.

    I understand that by having my child participate in the CONCRETE & CRANES Vacation Bible School Program, pictures and/or video may be taken of my child and me. I give my permission for Addisville Reformed Church to use these pictures and/or video in their publications and on their website.

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  • Liability Release Form Related to Coronavirus/COVID-19

    By signing up, you and your child(ren) are agreeing to the statement below:
    I acknowledge COVID-19 is a risk, and agree to hold Addisville Reformed Church and its leaders harmless from any and all liability should I or any member of my family be exposed to coronavirus or contract COVID-19 as a result of attending Vacation Bible School or being in the church building. Further, I agree to abide by the safety guidelines of Addisville Reformed Church and not to come into the building if I have a fever or cough, or know or suspect I may be positive for the virus. 
    I understand that by having my child participate in the CONCRETE & CRANES Vacation Bible School Program at Addisville Reformed Church, that is following the safety guidelines keeping with the current CDC recommendations for summer camps, that I agree to assume all risks of attendance and participation for my family, and waive any liability against the church and any other parties.
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    For more information, please contact Natalie Kelly at 215-357-4277 or Registration closes by June 1st — submit forms online before 12 AM on JUNE 1, 2021. Some classes may close sooner, based on demand. Class sizes are limited; registration forms are accepted on a first-come, first-serve basis.
    Please provide a Parent/Guardian Email Address (to receive confirmation of registration & a Welcome Letter): 
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