VBS 2018 Sign-Up
We are so excited for VBS Shipwrecked June 11th-15, 9 am - 12

Please use one form per child. Thank you!

Registration is now closed for our Pre-K class. Our Preschool Class is now full! Contact Becca@fccmoline.org with questions.

Child's Name *
Your answer
Child's Gender: *
Child's Birthday: *
MM
/
DD
/
YYYY
Grade to enter in Fall 2018: *
Junior Counselor (Grade entering in fall 2018) Grades 7th-12th
Medical Conditions, food allergies, or special needs to be aware of: *
Your answer
Parent (s): *
Your answer
Address: (Please include city and state) *
Your answer
Phone number: *
Your answer
Primary caregiver cell phone number: *
Your answer
Who's number is this? *
Your answer
Email: *
Your answer
Emergency Contact: *
Your answer
Who will drop off and pick-up? *
Your answer
Does your child need transportation? *
Permission for photos in FCC publications or the FCC website *
Permission for photos to be used on FCC social media *
Do you have a home church? *
How did you hear about our VBS? *
Parent Volunteer *
Would you like to contribute to Vacation Bible School at FCC Moline? Please follow the link below and select Vacation Bible School.
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This form was created inside of First Congregational Church.