VBS Registration 2021 - King of the Jungle - Rechoboth Baptist Church
July 19 - 23 Times 6:30 - 9:00 pm
Student's First Name
Student's Last Name
Student's Gender
Clear selection
Date of Birth (Must be 4 by Aug. 15)
MM
/
DD
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YYYY
Parent / Guardian Name
Phone Number
Email Address
Mailing Address
Grade Level for Upcoming School Year
Allergies
Person(s) Authorized to pickup student
Anyone specifically prohibited from picking up student(s)
Other VBS Student(s) that may be picked up with you (including siblings)
Submit
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