EMBC VBS Registration
Event Timing: June 9th - June 13th 6:00pm to 8:30pm
Event Address: 315 E Mountain Rd, Gilmer, TX 75645
Ages 4 years to 6th grade
Childs First Name *
Your answer
Childs Last Name *
Your answer
Childs Age *
Your answer
Grade completed *
Required
Address
Your answer
City *
Your answer
State *
Your answer
Phone Number *
Your answer
Parents Email
Your answer
Parents Name *
Your answer
Who is allowed to pick up your child from VBS? *
Your answer
Are you a member of a church? If yes, where? *
Your answer
Does your child have any food allergies? If yes, please list.
Your answer
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