CEC in Livingston VBS 2018 Registration
Christian Evangelical Church in Livingston - 71 Old Road Livingston NJ 07039
2018 Vacation Bible School Registration
August 6, 2018 (Mon) to August 10, 2018 (Fri) from 8:45 am to 12 noon
Age Group (Kindergarten to Grade 6 - for Fall Attendance)
Last Name *
Your answer
First Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Zip *
Your answer
Age *
Your answer
Birthday *
MM
/
DD
/
YYYY
School grade child will attend in the Fall *
Home Phone *
Your answer
Parent Cell Phone(s) *
Your answer
Parent Email *
Your answer
Parent(s) name(s) *
Your answer
Parent(s) work phone(s) *
Your answer
In case of emergency, contact NAME and PHONE *
Your answer
Allergies or other medical conditions
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Name of home church, if any
Your answer
Special Notes
Any other information you would like us to know
Your answer
Permission for CEC in Livingston to use pictures of my child on church website for information or promotional purposes. We will not publish any names so everyone will remain anonymous. *
Parent/Legal Guardian filling out this registration *
Your answer
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