VBS 2019 Registration | Power Up: Raise Your Game!
Ages: 5- 17
Date: July 8 - July 12
Time: 6:30PM - 8:30PM
Location: NEW LIFE CHURCH COOLJC | 157 Washington St. Central Falls, RI 02863
Child's First Name: *
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Child's Last Name: *
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Child's Birthdate: *
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Child's Age: *
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Parent/ Guardian First Name: *
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Parent/ Guardian Last Name: *
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Mailing Address: *
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City: *
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State: *
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Zip: *
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Parent/ Guardian Phone Number: *
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Parent/ Guardian Email Address: *
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Emergency Contact Name: *
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Emergency Contact Phone Number: *
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Allergies or Special Needs *
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Will you be joining us for dinner on Friday's Family Night (July 12 @ 6:30PM)? *
If you will be attending, how many guests will you be bringing (including yourself)? *
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How did you hear about us? *
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