VBS 2017 Registration
August 6th-9th from 6:15 - 8:30 PM.
1000 Bales Chapel Rd. Jamestown NC, 27282
Child's Full Name:
Parent of Guardian's Full Name:
Child's Date of Birth:
Child's Age/ Grade (Just Completed):
Pre-K and 1st Grade
2nd, 3rd, or 4th Grade
5th, or 6th Grade
Please list any allergies:
Does your child have an EpiPen?
Who is allowed to pick up your child?
How did you find out about us?
Through the Mail
During VBS we will also post pictures of the children and activities, please indicate below if we are allowed to post pictures of your child (No name or identifying information will be provided) on our website:
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