VBS Pre-Registration 2019
Please fill out this form for your child for Vacation Bible School at Living Christ Church (151 South Broadway, Nyack, NY) from July 15-19, 2019, from 6:30-8:30 pm. If you have questions about this form, please contact the church office at 845-358-3125
Child's First and Last Name
Father/Guardian's First and Last Name
Mother/Guardian's First and Last Name
Current Address (Street, City, State, Zip Code)
Who has permission to pick up your children from VBS?
Emergency Contact (Name & Phone Number)
Please provide the full name and best contact phone number for the individual(s) we will contact if there is an emergency.
Child's Grade (in the fall)
Please specify allergies your child may have (including medications or food). If none, write "N/A"
Is your child bringing any medication?
Please list medication and use and/or dosage directions. If none, write "N/A"
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