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It's that time again for VBS at Hickman Mills Church of Christ!!

When: Saturday June 10th 9am-12pm

Where: Hickman Mills Church of Christ
11610 US-71, Kansas City, MO 64137
(816) 761-2659

Who: This year we are excited to announce that we will have classes for kids starting at 3 years old(potty trained) and will even have an adult class as well!! So come one come all!!

Email address
First Name
Your answer
Last Name
Your answer
Gender
Birthday
MM
/
DD
/
YYYY
Age
by the time of VBS(6/10/17)
Your answer
Grade Just Finished
2016-2017 school year
Your answer
Parent(s) Name:
ex: Jack and Annie Smith
Your answer
Phone Number
Your answer
2nd Phone Number
This can be for the other parent in case the first parent is unreachable
Your answer
Street Address
Your answer
City, State
Your answer
Zip Code
Your answer
Email Address
Your answer
Emergency Contact
(other than the parents listed above. Name and Phone Number)
Your answer
Relation to Child
Your answer
List Any Medical Issues
Your answer
Home Church
Your answer
T-Shirt Size
YXS, YS, YM, YL, AS, AM, AL, AXL
Your answer
How did you hear about our VBS?
If it was a friend please list their name
Your answer
A copy of your responses will be emailed to the address you provided.
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