Vacation Bible School Registration Form

Use the form below to register your children for 2018 Vacation Bible School: July 23-July28, 6:30 p.m. - 8:00 p.m.

Student's Name*
Parent/Guardian/Family Name*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone 1*
Phone 2
Student Date of Birth
Student Age
Last School Grade Completed*
Home Church
Friends of your child at this church
Special Needs/Allergies/Medications*
Emergency Contact Information*
Please provide the names and best phone numbers of two people we can contact in case of an emergency.
Dismissal Information*
Name(s) of person(s) who may pick up this child from VBS.

Oct 2018