Mill Creek Bible Church VBS Registration 2019
Please fill out one form per child.
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Age *
Your answer
Last Grade Completed *
Allergies or other Medical Conditions *
Your answer
Parent's/Guardian's Names (First and Last) *
Your answer
Parent's/Guardian's Phone Number *
Your answer
Home Address *
Your answer
Parent's/Guardian's Email Address *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact's Phone Number *
Your answer
The following people have my permission to pick up my child(ren) from VBS
Your answer
Home Church *
Your answer
I hereby authorize Mill Creek Bible Church to use my child(ren)'s image, photo, video, or likeness of those named to be used by Mill Creek Bible Church to make a video for the end of VBS and to display on their social media and print. *
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