Vacation Bible School Registration

Sunday-Thursday -- August 7-11, 2011 -- 6:30-8:30pm nightly

Parent/Guardian Name:
Address:
City: State: Zip Code:
Phone:
Email:

Church:
Attend: Regularly Occasionally Seldom

Emergency Contact:
Emergency Contact Phone:

If you have more than four children, please submit the form again with additional names.

First Child:

Name: (If different from above.)
Birthdate (MM/DD/YYYY): Grade Completed:
Notes:

Second Child:

Name: (If different from above.)
Birthdate (MM/DD/YYYY): Grade Completed:
Notes:

Third Child:

Name: (If different from above.)
Birthdate (MM/DD/YYYY): Grade Completed:

Fourth Child:

Name: (If different from above.)
Birthdate (MM/DD/YYYY): Grade Completed:
Notes:

VBS is coming! August 7 - 11

Vacation Bible School Registration

Sunday-Thursday -- August 7-11, 2011 -- 6:30-8:30pm nightly

First Child:

Second Child:

Third Child:

Fourth Child:

VBS is coming!
August 7 - 11