VBS 2019 Registration Form
July 8th -12th, 2019
7:00 pm - 8:45 pm
Tabernacle of Christ Church
483 Main St, Beacon, NY 12508
Questions Contact: Marisol Wager wagercmc@gmail.com
Email address *
Child's name *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
Home Phone Number
Your answer
Cell Phone Number *
Your answer
Child's Birth date *
MM
/
DD
/
YYYY
Last grade completed in school *
Medical Information: Please include any medical or other information we may need to know. Ex. any food allergies *
Your answer
Emergency Contacts (other than listed above). Please include contact number. *
Your answer
Dismissal Information: Name(s) of person who may pick up your child from VBS - If more than one person please specify *
Your answer
Is transportation needed? *
Permission to take photos and post on Church website or on Social media? *
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