VACATION BIBLE SCHOOL registration form

July 23 - July 27, 2018

6:30 - 8:30 pm

please note: to register your child must have completed Kindergarten - 5th grade.

Child's Name *
Child's Name
Date of Birth
Date of Birth
M/F
Parent/Guardian
Parent/Guardian
Home Address
Home Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Work Phone
Work Phone
Does your child have any allergies?
Emergency Contact
Emergency Contact
Phone
Phone