VBS 2017 Registration Form - (Page 1 of 3)
The Church of the Good Shepherd and Reid Memorial Presbyterian Church are partnering once again to provide rising PreK - 5th Grade students a wonderful, faith filled week.

Date: June 5 – June 9, 2017
Time: 9:30am – 12:30pm
Location: Church of the Good Shepherd, 2230 Walton Way, Augusta GA
Eligible Participants: Rising PreK – 5th Grade Students
Donation: $10.00 per child
Click here to pay through PayPal:
https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=SQDJ9XAUS442L

Registration Deadline: May 27, 2017

Child's Name
Your answer
Entering Grade
Date of Birth
On or before 9/1/2013
Your answer
Gender
Is your child a special needs child?
Home Church
Your answer
Parent/Guardian
Your answer
Cell #:
Your answer
Parent/Guardian
Your answer
Cell #:
Your answer
Street Address
Your answer
City, State, Zip
Your answer
Home Phone
Your answer
Work Phone
Your answer
Email Address
Your answer
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