Vacation Bible School 2019
Online Registration
16700 Old Frederick Road, Mount Airy
After clicking SUBMIT, you'll have the opportunity to register additional children. If you have multiple children, please complete an individual form for each. If you encounter any difficulties, please contact the church office at 410-489-4321.

Sign up by June 30 to receive a free The Incredible Race t-shirt for your child!

PARENT & FAMILY Information
Parent's First & Last Name *
Your answer
Parent's Email Address *
Your answer
Parent's Cell Phone *
This the number where you can be reached while your child is with us at Vacation Bible School.
Your answer
Parent's Street Address *
Your answer
Parent's City, State, & ZIP *
Your answer
Parent's Current Church *
How did you hear about us? *
Who can pick up your child? Please give full legal name (first/last) for each person and their relationship to your child.
Your answer
EMERGENCY CONTACT Information
This information will only be used in the event that we cannot reach you while your child is here at Vacation Bible School.
Emergency Contact's First & Last Name *
Your answer
Emergency Contact's Cell Phone *
Your answer
Emergency Contact's Relationship to Child *
Your answer
CHILD Information
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Last Grade Completed *
Child's Dietary Needs or Other Significant Health or Medical Concerns *
Child's T-shirt Size *
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