Special Needs VBS 2018
For any child with special needs ages 4 years old to 10 years old

When: June 4th - June 8th; 9:15 AM - 12:15 PM

Where: Grace Chapel Church of Christ
6755 Majors Road, Cumming, GA 30040
678.455.6845

Contact us at: BrightLightsMinistry@gmail.com

Grace Chapel cares for each participant in our Special Needs Vacation Bible School. The following questions are asked for the benefit of your child and so that we may provide the best experience and safest environment for everyone involved. Grace Chapel and our volunteers respect your family’s right to privacy. Any information shared from this form is communicated with those directly caring for your child and only on a “need to know” basis. Please answer the following questions that apply to your child and that may help our church best minister to your child.

Email address *
Child's First & Last Name *
Your answer
Address
Your answer
Child's age at time of VBS *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Gender *
Parent/Guardian Name(s) *
Your answer
Emergency Contact Information *
Your answer
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