Vacation Bible Extreme

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Event Timing: June 21st-24th, 2021 6PM - 8PM
1848 S Cochran Charlotte MI 48813
Contact us at (517) 541-5433

Child's Full Name *

Child's Date Of Birth *

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Parent/Guardian Name *

Address

Cell Phone *

E-mail *

Incase of Emergency Name *

Incase of Emergency Phone Number *

List of allergies or health conditions *

Sport *

Flag Football

Basketball

Volleyball

Photos of my child may be used in future Real Life Church promotions.

Yes

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My Child has permission to attend and participate in VBX Summer Camp at Real Life Church

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