Lakeview Chapel VBS Registration Form
Please fill out the form below (once per child) to register for this year's program, The Armor of God.

The program is hosted by Lakeview Chapel July 15-18, 5:45 - 8:00pm, located at 185 Day Hollow Road, Owego NY.
Child's Name *
Child's Gender
Clear selection
Child's Age *
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's last school grade completed *
Name of Parent(s) / Guardian(s) *
Street Address *
City *
State *
Zipcode *
Home Telephone *
Parent/Caregiver's Cell Phone *
Email Address *
Home Church
T-Shirt Size (Youth) *
Allergies or other Medical Conditions
In Case of Emergency Contact Name *
Emergency Contact Phone *
Emergency Contact Relationship to Child *
Submit
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