Richfield VBS Registration

5:30pm-8:30pm; July 16-19, 2018. Ages 4 yrs-old through completed 5th Grade.
Please fill out a separate form for each child. If you have a question, call the church at 254-772-2340.
SHIPWRECKED 2018!
Child's Name *
Your answer
Child's Age *
Your answer
Child's Completed Grade in School *
Your answer
Child's Gender *
Parent Name(s) *
Your answer
Street Address *
Your answer
City, State, Zip Code *
Your answer
E-mail Address
Your answer
Phone number(s) (Cell Preferably) *
Your answer
Emergency Contact Besides Parent *
Your answer
Emergency Contact Relationship to Child *
Your answer
Emergency Contact Phone Number *
Your answer
Child's Allergies or "None" *
Your answer
Home Church
Your answer
Name(s) of person(s) who may pick up child
Your answer
Name of friend your child might want to be with
Your answer
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