2020 Vacation Bible School Registration
VBS is June 10th - 12 from 6:00 PM-8:00 pm. It is open to ALL children ages 5 to 11. You can register multiple children from the same family using this form.

Parkway House of Prayer is located at 3230 King Street Roanoke Va, 24012.

Please contact Melanie Thompson with any questions. email: timewithmelanie@gmail.com phone: (540) 982-0115
Child's Last Name *
Your answer
Child's First Name *
Your answer
Birthday *
MM
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DD
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YYYY
Grade Entering in Fall 2020 *
Your answer
What school does your child attend? *
Your answer
Allergies
Your answer
Other health information
Your answer
Address *
Your answer
Parent or Guardian's Name(s) *
Your answer
Phone Number 1 (List if the number is mom, dad, etc.) *
Your answer
Phone Number 2 (List if the number is mom, dad, etc.) *
Your answer
Can we text you reminders about VBS? *
Required
Email *
Your answer
Do you have a home church? If you attend somewhere other than PHOP, please list the name of your church under Other. *
Emergency Contact (Not Parent) *
Your answer
Emergency Contact Phone *
Your answer
Do you need to register additional children? *
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