Kingdom Rock (VBS) Registration
Lord of the Harvest Church
July 26-28 at 6:30pm-8:30pm
7333 McArdle Rd. Corpus Christi, TX. 78412
Child's Name *
Your answer
Grade Completed
Your answer
Birthday *
MM
/
DD
/
YYYY
Parents/Guardian name *
Your answer
Parents/Guardian Number *
Your answer
Emergency Name *
In an emergency we may use this number to contact parents/guardians.
Your answer
Emergency Number
In an emergency we may use this number to contact parents/guardians.
Your answer
Parent's Email
Your answer
Home Adress *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Siblings Names Atteding Kingdom Kids
Your answer
People who may pick up the child from VBS (Must be an adult over 18 years old)
Your answer
Allergies/Medical Concerns *
By submitting this form and clicking "Next" you agree to "MINOR RELEASE Document". (We will have a paper copy of the "Minor Release Document" at check-in to fill out.)
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