Register Now to Save Your Seat!
July 7-10, 2019 | 6:30 - 8:30 pm nightly

McConnell Road Baptist Church, 3911 McConnell Road, Greensboro, NC 27406

Contact us at (336) 697-8506 or mjtilley@mcconnellroadbaptist.org

Please complete this form for each child

Email address *
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Address *
(For example: 123 Main Street, City, NC 99999)
Your answer
Child's Birthdate *
MM
/
DD
/
YYYY
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Allergies
Your answer
Parent(s) Authorized for Pickup *
Please list all names of relatives that you approve for pickup of this child
Your answer
School Grade Entering This Fall *
VBS for Adults *
Please let us know if you want to participate in a class for adults during VBS or if you'll plan to drop off your children.
Special Instructions
Your answer
By submitting this registration form, I give permission for my child to attend Vacation Bible School at McConnell Road Baptist Church. In the event of injury, I release McConnell Road Baptist Church from any claim. I give permission for the person in charge of the event to seek medical services, if needed. *
Required
Photos taken at this event of my child may be used on the church website and/or social media sites. *
Do you want to be notified of other McConnell Road Baptist Church events and activities? *
If you say yes, you'll be added to Pastor Tilley's "Just a Word" email list, which usually gets about 1 email per month.
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