Kingdom Chronicles Vacation Bible School


Event Timing: June 6-10, 2016 6:00 PM - 8:15PM
Event Address: Waterman Bible Church - 500 S Birch, Waterman
Contact us at 815-264-3908

Please use the form below to register your child for our VBS! Please complete a separate form for each child registered.

Child's Name *
Your answer
Gender *
Birthdate *
MM
/
DD
/
YYYY
Grade Completed (as of May/June 2016) *
Address *
Your answer
Email Address
Your answer
Parents Name (s) and Best Phone# to Contact *
Your answer
Name of Emergency Contact and Phone Number
Your answer
Name of Home Church
Your answer
My Child is a Guest of:
Your answer
Does your child have Food Allergies/Concerns? *
Your answer
Does your child have Medical Concerns or Conditions we need to be aware of at VBS? *
Your answer
Who has permission to pickup your child? *
Your answer
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