Vacation Bible School 2017
 

Name of Child #1 (required)

Male / Female? (required)

Child's Age (required)

Child's Date of Birth (required)

Child's 2017-2018 School Grade (required)

Parent's Name (required)

Parent's Address (required)

Parent's Email (required)

Best Phone Number for Parent (required)

Is this your cell or land line

Emergency contact name & phone during VBS

Are there any allergies or medical condition(s) we should be aware of?

Is there any additional information you would like to provide?

Name of Child #2 FROM THE SAME FAMILY (required)

Male / Female? (required)

Child's Age (required)

Child's Date of Birth (required)

Child's 2017-2018 School Grade (required)

Same address as child #1? (if no, please list here)

Are there any allergies or medical condition(s) we should be aware of?

Is there any additional information you would like to provide?

Name of Child #3 FROM THE SAME FAMILY (required)

Male / Female? (required)

Child's Age (required)

Child's Date of Birth (required)

Child's 2017-2018 School Grade (required)

Same address as child #1? (if no, please list here)

Are there any allergies or medical condition(s) we should be aware of?

Is there any additional information you would like to provide?

PLEASE NOTE:  By registering your child(ren) for VBS, you hereby give permission for your son/daughter to be photographed or videotaped for church promotional purposes.