Vacation Bible School 2018 Registration for Child Participants
Join us for the Everywhere Fun Fair!

Vacation Bible School is open to children ages 4 through fifth grade.

June 25-29, 2018
9:00 am-12:15 pm
10701 Old Georgetown Road, Rockville, MD 20852
Contact:
Marlise Burr-Asher: littlesilverinn@verizon.net
Rev. Shelby Etheridge Harasty: associate@saintmarkpresby.org

Child's Name *
Your answer
Child's age (and grade if applicable) *
Your answer
Parent's name(s) *
Your answer
Parent's email *
Your answer
Parent's phone number (best way to reach you) *
Your answer
Home Address *
Your answer
What days will you attend? *
Required
Dietary restrictions (a snack will be provided each day)
Your answer
Allergies or medical conditions to be aware of
Your answer
Who is authorized to pick up your child? *
Your answer
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