"On Earth As In Heaven" VBS Registration
June 24-26, 2022 @ Clemmons Moravian Church for children ages 4-10!
3535 Spangenberg Ave, Clemmons, NC 27012
VBS this summer focuses on the Lord's Prayer, and the phrase "Your Kingdom come, Your will be done on earth as in heaven." For questions, please contact Randy Fulton (dce@clemmonsmoravian.org) or call the church office at (336) 766-6273.
  Friday, June 24: 5:45 - 8:15 pm (includes dinner)
  Saturday, June 25: 9:45 am - 12:30 pm (includes lunch)
  Sunday, June 26: 9:45 am gathering (children will sing in our 10:30 am worship service)

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Email *
Parent/Guardian Name (Last, First) *
(if another Parent/Guardian may be dropping off/picking up, please share their name in Section 2)
Parent/Guardian Cell Phone (xxx) xxx-xxxx *
Address Line 1 *
Address Line 2 (if needed)
City *
State *
ZIP Code *
Child #1 Name (Last, First) *
(You can register additional children in section 2)
Child #1 Age *
4
5
6
7
8
9
10
Age
Child #1 allergies or relevant medical/health information
Emergency Contact Name *
Emergency Contact Phone Number (xxx) xxx-xxxx *
Emergency Contact Relationship to Child *
People in addition to listed Parent(s)/Guardian(s) who are authorized to pick up your child *
What days do you plan on attending? *
Required
We invite all VBS children and their parents/siblings to join us for our closing lunch on Saturday at 12 noon. How many total people from your family will be eating lunch with us on Saturday?
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Home church (optional)
Any additional comments/concerns that will help us to bless and care for your child(ren)
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