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VBS at SJCC
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* Indicates required question
Email
*
Your email
Child’s Name (First & Last)
*
Your answer
Grade Level (2022-2023 School Year)
*
Preschool (at least 3 years old)
Kindergarten
1st
2nd
3rd
4th
5th
Child's Birthday
*
Your answer
Parent/Guardian Name(s)
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Parent/Guardian Email
*
Your answer
Emergency Contact (Name & Phone Number)
*
Your answer
Does your child have any food allergies or medical conditions?
*
Your answer
Anything else we should know about your child?
Your answer
I give my child permission to attend Vacation Bible School at South Jefferson Christian Church and I understand that I will have to pick up my child promptly at 3 PM.
*
Yes
Please type Parent/Guardian Name below to consent to SJCC Video/Photo Release
*
Your answer
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