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Vacation Bible School Registration 2017
Event Timing: June 15-16th 6-8pm, June 17th 9-2pm
Event Address: 4815 Six Forks Road, Raleigh, NC 27609
Contact us at (919) 787-3740
VBS Theme 2017
Participant's First Name *
Your answer
Participant's Last Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Age as of 8/31/2016 *
Your answer
Last Grade Completed
Your answer
Parent/Guardian's Name *
Your answer
Street Address
Your answer
City
Your answer
Zip Code
Your answer
Home Number
Your answer
Cell Number/Alternate Number *
Your answer
Email *
Your answer
Saturday lunch: Taco Wrap with bean & rice & fruit. Please let us know of any food allergies (gluten, peanuts, etc), medical, or special needs. (or answer N/A) *
Your answer
Estimate what days will you attend? *
Required
Emergency Contact #1 (Name & Number) *
Your answer
Emergency Contact # 2 (Name & Number) *
Your answer
Emergency Contact # 3 (Name & Number) *
Your answer
Are you a member of Trinity Baptist Church *
If no, are you the guest of a member? Please list name.
Your answer
Do you attend a church?
If yes, what church do you attend?
Your answer
May we have permission to photograph your child during VBS?
May we have permission to use your child's photograph in church publications?
Parent/Guardians Initials (indicating you have completed this form for our records)
Your answer
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