VBS 2019 Registration
August 5-9 2019, 9:30am-12pm

Fellowship Baptist Church
5607 Wright Avenue
Racine, WI 53406
262-633-3206

ROAR! - Life is wild, God is good
Child's Name *
Your answer
Child's Gender *
Child's Age *
Your answer
Date of Birth *
Your answer
Last school grade completed *
Your answer
Name of Parent(s) *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Home Telephone *
Your answer
Parent/Caregiver's Cellphone *
Your answer
Home email address *
Your answer
Home church
Your answer
Allergies or other medical conditions
Your answer
Emergency contact name: *
Your answer
Emergency contact phone *
Your answer
Emergency contact relationship to child *
Your answer
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