Vacation Bible School Registration
June 19-23 from 6:00 - 8:30 PM
Open to students who've recently completed Kindergarten - 5th Grade
Child's Name:
Your answer
Date of Birth
MM
/
DD
/
YYYY
Last Grade Completed (Kindergarten - 5th)
Your answer
Age
Your answer
Parent/Guardian's Name
Your answer
Address
Your answer
Home Phone
Your answer
Alternative Phone
Your answer
Please list any food allergies or type "None"
Your answer
VBS Leaders have permission to photograph/film the minor designated above in any manner or form for any lawful purpose associated with this VBS Program.
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