Vacation Bible School
Event Timing: Tuesday, July 24th through Thursday, July 26th, 6:00 pm - 8:30 pm
Event Address: 14506 E. 39th St., Independence, MO 64055
Contact Kathy Vest @ 816-461-1101 or kathy.vest@icumc.org
Student's Name: *
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Birth Date: *
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Grade Fall 2018 *
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Street Address: *
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City/State/Zip *
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Parent's Name: *
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Parent's Phone Number during VBS hours: *
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Email *
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Other contact name: *
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Other contact's phone: *
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Who will pick student up? *
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Does student have any allergies? *
If you answered yes above, please list allergies:
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What church does student attend, if any?
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