FPCLC - ROAR 2019 VBS Registration June 10th - 14th 8:30am - 11:30am
***This VBS is for 4 years old thru 5th Grade***

FIRST PRESBYTERIAN CHURCH OF LAKE CITY FL

Church Address: 697 SW Baya Drive, Lake City, FL 32025

Admin Office Address: 608 West Duval, Lake City, FL 32055

Mailing Address: PO Box 469, Lake City, FL 32056

Office Ph# 386-752-0670

Email address *
ROAR
Child #1 *
Your answer
Child #2
Your answer
Child #3
Your answer
Parent's Email *
Your answer
Child's Gender *
Child's Date of Birth *
MM
/
DD
/
YYYY
Last School Grade Completed (each child) *
Your answer
Do you grant First Presbyterian Church of Lake City Fl. permission to use photographs and/or videos of your child in its publications (newsletters, slideshows, worship bulletins), including website entries and FPCLC social media accounts? *
Name of Parents/Guardians *
Your answer
Street Address, City, State & Zip *
Your answer
Home/Cell Phone Number *
Your answer
Additional Phone Number
Your answer
Home Church
Your answer
Allergies or other medical conditions *
Your answer
Who will be picking up child(ren)? *
Your answer
In Case of Emergency Contact *
Your answer
In Case of Emergency Phone Number *
Your answer
In Case of Emergency Contact's Relationship to Child *
Your answer
Misc. information you would like us to know about your child.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of First Presbyterian Church - Lake City, FL. Report Abuse - Terms of Service