Vacation Bible School Registration
Event Timing: July 8-12, 2019
Event Address: 293 Place St., Lucknow
Contact us at (519) 528-3133 or
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Email *
Child's Name (First & Last) *
Child's Gender *
Child's Age (as of December 31, 2018) *
Child's Birthdate *
Medical Information (allergies, asthma, etc.) *
Parent/Guardian Name *
Address *
Home Phone # *
Cell Phone # *
Home Church
In Case of Emergency Contact (name & phone #) *
Would you like to purchase a CD with this year's music for $5 *
If registering multiple children, you only need to check "Yes" once. If you want more than one CD per family, please note it in the comments section. Thanks!
Questions or Comments
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