Special Needs VBS 2017
For Children ages 4 years to 10 years old
Event Timing: June 5th - June 9th; 9:15 AM - 12:15 PM

Event Address: Grace Chapel Church of Christ
6755 Majors Road, Cumming, GA 30040
678.455.6845

Contact us at: Brightlightsministry@gmail.com

Grace Chapel cares for each participant in our Special Needs Vacation Bible School. The following questions are asked for the benefit of your child and so that we may provide the best experience and safest environment for everyone involved. Grace Chapel and our volunteers respect your family’s right to privacy. Any information shared from this form is communicated directly with those caring for your child and only on a “need to know” basis. Please answer the following questions that apply to your child and that may help our church best minister to your child.

Email address
Child's First & Last Name
Your answer
Address
Your answer
Child's age at time of VBS
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Child's Gender
Parent/Guardian Name(s)
Your answer
Emergency Contact Information
Your answer
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