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VACATION BIBLE SCHOOL 2021
Wednesdays: July 7, 14, 21, 28 & Aug 4
6 pm - 7:30 pm
* children who have
completed
kindergarten
through fifth grade
ONLINE REGISTRATION
Please complete one registration
for
each household/address and include specific information for each child at the child registration section (below). Feel free to use a second registration form if you have more than six children from the same household/address.
BE SURE AND HIT THE SUBMIT BUTTON AT THE BOTTOM OF THE SCREEN AND LOOK FOR THE CONFIRMATION MESSAGE.
(For a second registration form, refresh your browser, and the form will return.)
*
Indicates required field
Parent/Guardian Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mailing Address (if different)
*
Line 1
Line 2
City
State
Zip Code
Country
Home Phone
*
Mobile Phone
*
Work Phone
*
Email
*
Authorized people who may pick up your child(ren) Name / Phone Number
*
First Emergency Contact Name / Phone Number
*
Second Emergency Contact Name / Phone Number
*
Does your child(ren) attend Sunday School and/or Church each week?
*
Yes, regularly
Occasionally
No
If so, which Church?
*
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
CHILD REGISTRATION
(1) Child's Name
*
First
Last
Children who have completed kindergarten - sixth grade
(1) Child's Birthdate
*
Children who have completed kindergarten - sixth grade
(1) Last Grade COMPLETED
*
Children who have completed kindergarten - sixth grade
(1) Medical Information: (What do we need to know? Please include food allergies.)
*
(2) Child's Name
*
First
Last
Children who have completed kindergarten - sixth grade
(2) Child's Birthdate
*
Children who have completed kindergarten - sixth grade
(2) Last Grade COMPLETED
*
Children who have completed kindergarten - sixth grade
(2) Medical Information: (What do we need to know? Please include food allergies.)
*
(3) Child's Name
*
First
Last
Children who have completed kindergarten - sixth grade
(3) Child's Birthdate
*
Children who have completed kindergarten - sixth grade
(3) Last Grade COMPLETED
*
Children who have completed kindergarten - sixth grade
(3) Medical Information: (What do we need to know? Please include food allergies.)
*
(4) Child's Name
*
First
Last
Children who have completed kindergarten - sixth grade
(4) Child's Birthdate
*
Children who have completed kindergarten - sixth grade
(4) Last Grade COMPLETED
*
Children who have completed kindergarten - sixth grade
(4) Medical Information: (What do we need to know? Please include food allergies.)
*
(5) Child's Name
*
First
Last
Children who have completed kindergarten - sixth grade
(5) Child's Birthdate
*
Children who have completed kindergarten - sixth grade
(5) Last Grade COMPLETED
*
Children who have completed kindergarten - sixth grade
(5) Medical Information: (What do we need to know? Please include food allergies.)
*
(6) Child's Name
*
First
Last
Children who have completed kindergarten - sixth grade
(6) Child's Birthdate
*
Children who have completed kindergarten - sixth grade
(6) Last Grade COMPLETED
*
Children who have completed kindergarten - sixth grade
(6) Medical Information: (What do we need to know? Please include food allergies.)
*
Comments
*
Submit