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2018 Vacation Bible School Registration
**Free event** June 25th - 29th, 5:30 - 8:00 pm, dinner will be served each night, accepting ages 3-11
Child's Information
(Please fill out a separate form for each child you are registering)
First Name: *
Your answer
Last Name: *
Your answer
Gender: *
Age: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Last grade completed in school? (if applicable)
Your answer
Allergies:
Your answer
Parent/Guardian Information
First Name: *
Your answer
Last Name: *
Your answer
Address: (please include zip code) *
Your answer
Mobile phone number: *
Your answer
Secondary phone number:
Your answer
Email address: *
Your answer
How did you hear about VBS? *
Your answer
Emergency Contact (other than parent/guardian)
Full name: *
Your answer
Mobile phone number: *
Your answer
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