Vacation Bible School 2017
June 19-23rd 9am-12pm at First Presbyterian Church of Harbor Springs
Medical and other release forms will be emailed and are due by June 19th
Student Name (First and Last) *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Email Address *
Your answer
Address *
Your answer
Cell Phone Number of Parent *
Your answer
Home Phone Number of Parent
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
Last Grade of School Completed *
Your answer
Home Church
Your answer
Allergies/Important Medical Information *
Your answer
Emergency Contact #1 Name and Phone Number *
Your answer
Emergency Contact #2 Name and Phone Number *
Your answer
Name(s) and relation(s) of person(s) able to pick up your child(ren) from VBS *
Your answer
Phone Numbers of those able to pick up your child from VBS *
Your answer
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