VBS 2017 Registration Form
Online registration for Vacation Bible School at Corinth Baptist Church

(Please fill out one form for each child being registered)

Child's Name *
First and last name
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Gender *
Home Address *
(please include city, state and zip code)
Your answer
Home Phone Number (please include area code) *
ex. (804) 993-4290
Your answer
Child's Grade (as of September 2016) *
(select one)
Does your child attend church?
If yes to the previous question, which church? (If no, please type NA) *
Next
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