Galactic Starveyors (VBS 2018- Heath Church of Christ)
Heath Church of Christ Vacation Bible School
June 11-15, 2018, 9:00-Noon
4 Year Old's through 6th Grade
Children's Registration
Child's First Name *
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Child's Last Name *
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Child's Birthdate *
MM/DD/YYYY
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Child's Gender *
Child's Grade Completed By June 2018 (4 Year Old's through 6th Grade) *
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Age *
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Mark any of the areas your child may be interested in helping out with on the stage:
First Name of Parent/Guardian *
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Last Name of Parent/Guardian *
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Street Address *
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City *
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State *
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Zipcode *
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Contact Phone *
please include area code
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Home Phone
please include area code
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Cell Phone
please include area code
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Work Phone
please include area code
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Emergency Contact & Number *
Include Name and Phone Number
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Special Needs/Alergies
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Person Responsible For Pick Up *
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Is there a friend (same age) your child wants to be with? *
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Phone Number Of Person Responsible For Pickup *
please include area code
Your answer
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