VBS Registration TRC 2017
Please submit one form for each child
July 31-August 3, 6:00pm-8:15pm
Child's First Name
Child's Last Name
Child's Age as of 7/31/17
Grade Entering Fall of 2017
Preschool--Age 4 or 5 (no 3-year-olds, please)
Allergies or Medical Information
Would you like your child placed in a Spanish-speaking group if space is available? (child should be fluent or mostly fluent in Spanish)
Parents' Names and Phone Numbers
Additional Emergency Contacts--Names and Numbers
Third Reformed Church
Who will be picking up the child? (child over 12, grandparent, friend, etc.) Please indicate name in "other" choice.
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