Join us for worship, Sundays at 10:00AM at 4310 Pleasant Valley Rd, Chantilly, VA 20151
Making Christ Known in Northern Virginia

Mark your calendar for Shepherd Gate’s 2017 VBS called: “Over the Moat: Drawbridge to the King”.

When:    On the last week of July 24–28th
Time:      9am–12pm
For:        Children ages 4 years old thru rising 3rd graders
Cost:      $40 per child

The week will be filled with fun & adventure of bible time, crafts, snacks, games, music and puppet shows.

click here to download our registration form or register online below

VBS Registration Form 2017

A complete registration must be completed for each child attending. Parents and guardians - fill out your information first. Below that you can fill out the information for your child.

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Parent/Guardian's name (required)

Your email (required)

Address-City-State-Zip (required)

Home Phone Number (required)

Work Phone Number

Cell Phone Number

Emergency Contact Name: (required)

Emergency Number: (required)

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NOTE: Pre-schoolers must be able to
perform bathroom tasks independently.
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Information about your child

Child's name (required)

What grade will your child enter in the fall (required)

Age at time of VBS (required)

Does your child have any allergies?

List Special Instructions for your child?

T-Shirts are included in the cost and guaranteed ONLY if registration and payment are turned in by July 13th.

Indicate T-Shirt size for your child
Y-XSY-SY-MY-LY-XL

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PERMISSIONS DECLARATION

Photo Permission: I
DoDo Not
give permission for my child to be photographed or recorded during VBS. We present a slide show to our congregation after VBS and also keep pictures in our church year book. Photos may also be posted to our website and Facebook page, though no identifying information will listed. Additionally, photographs may be used in our newsletters and bulletins.

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I give permission for my child to attend Shepherd Gate Church’s (SGC) Vacation Bible School (VBS) and all of the activities associated with that week. I hereby release SGC from responsibility and liability for any injury or illness that my child may sustain during this activity. In the event of an emergency, I authorize an adult leader of this activity as an agent for me, to consent to any treatment advised and supervised by a licensed physician. I expect to be contacted as soon as possible.

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Clicking on “Send” will serve as your affirmation to the above paragraph and that you believe that all the above information you filled out is true to the best of your knowledge.
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You may be curious to know why this form has been made so narrow. It is to make it easier for those with portable devices to fill this out.