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VACATION BIBLE SCHOOL 2017
JUNE 19-23, 2017
9 am - 12:30 pm
* children who have
completed
kindergarten
through sixth grade
(Refresh your browser after each submission
and the form will come back up)
ONLINE REGISTRATION
The safety and security of our children is of utmost importance. Consequently, please complete one form for
EACH
child that may be participating. Thank you so much!
Child's Name
*
First
Last
Children who have completed kindergarten - sixth grade
Parent/Guardian Name
*
First
Last
The safety and security of our children is of utmost importance. Consequently, please complete one form for EACH child that may be participating. Thank you so much!
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mailing Address (if different)
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Home Phone
*
Work Phone
*
Mobile Phone
*
Child's Birthdate
*
Children who have completed kindergarten - sixth grade
Last Grade COMPLETED in School
*
Children who have completed kindergarten - sixth grade
Medical Information: (What do we need to know? Please include food allergies.)
*
First Emergency Contact (other than listed above)
*
First
Last
First Emergency Contact Phone Number
*
Second Emergency Contact (other than listed above)
*
First
Last
Second Emergency Contact Phone Number
*
Other than Parent/Guardian listed above, who may pick up your child at the end of each VBS day?
*
Does your child attend Sunday School and/or Church each week?
*
Yes, regularly
Occasionally
No
If so, which Church?
*
How did you learn of our VBS? Please check all that apply.
*
Church Sign
Flyer
Have attended before
Friend (could you tell us which friend to the right)?
Other (could you tell us how to the right)?
Friend and/or Other?
*
May we have permission to photograph your child?
*
Yes
No
May we have permission to use your child's photograph for the purpose of future promotion of our VBS?
*
Yes
No
Comments
*
Submit